GIAO TRINH Anh Văn - YHCT 2

UNIT
TRADITIONAL MEDICINE:
1 METHOD OF FUNCTIONAL EVALUATION
ALUATION
A. BASIS
I. The purpose of the functional evaluation
There are two types of examination:
- The examination in Modern Medicine that confirms diseases and allows to estimate
the treatment effects of Traditional Medicine.
- The examination in Traditional Medicine that guides the practitioner in the elaboration
of treatment options.
1. The human tree of life
The functional evaluation of Traditional Medicine is based on the particular theory that
we can discover in the human tree:
- 6 Roots: 6 vital substances:
JING – XUE – QI – QI – SHEN – JIN YE (Chinese)
TINH – MÁU – KHÍ – KHÍ – THẦN - TÂN DỊCH (Vietnamese)
HORMONES – BLOOD – ENERGY – STRENGTH – MENTAL – BODY FLUID
- 12 BRANCHES: 12 Basic Functions (YIN and YANG) 12 Meridians.
- 6 LEAVES: 6 General Functions:
WOOD – FIRE – EARTH – METAL – WATER – SOURCE
- 2 FACES of the LEAF: a YIN face and a YANG face.
2. Purpose of functional evaluation
The purpose of the Functional Evaluation is primarily to answer 4 questions:
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a. What is the condition of the 6 ROOTS of the Tree of Life?
Functional Evaluation of the 12 Functions or 12 Meridians or 6 SYSTEMS.
b. What is the condition of the 6 LEAVES?
Functional Evaluation of the 6 GENERAL FUNCTIONS and the MAIN CAUSE.
d. What is the condition of the two sides of the leaf?
Functional Evaluation of Emptiness or Fullness Patterns of YIN or YANG, of

CHRONIC or ACUTE disease of the Causal Function.
II. THE RESULTS OF THE FUNCTIONAL SIX VITAL SUBSTANCES
We must answer the first question of the functional evaluation:
What is the state of six roots of the Human Tree of life?
We will understand the role of the 12 functions or 6 systems causing the production of
each vital substance:
JING – XUE –QI – QI – SHEN – JIN YE
Functional balance is very important especially in the case of chronic diseases or poor
general condition of the patient.
III. THE FUNCTIONAL EVALUATION OF THE 6 SYSTEMS OR 12 FUNCTIONS OR

12 MERIDIANS
Each of the 6 SYSTEMS contains a number of functions. The symptoms of the

functions are also symptoms of their systems.
6 SYSTEMS 12 BASIC FUNCTIONS
Respiratory System Lung – Large Intestine

Digestive System Spleen – Stomach
Urogenital System Kidney – Bladder
Muscular System Liver - Gall Bladder
Central Nervous System Heart – Small Intestine
Circulatory System
Autonomic Nervous System Pericardium – Triple Burner
The Functional Evaluation of the Meridians is based on the symptoms shown along the
meridians: pain, numbness, sensation of cold, warmth …
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It is based on palpation of alarm points:
MO points, SHU points, sensitive points
IV. THE FUNCTIONAL EVALUATION OF THE 6 GENERAL FUNCTIONS.
Six general functions: source, accumulation, motor, thermal, secretory, and absorbing
The 6 GENERAL FUNCTIONS and their relationship: SHENG and KO cycle.
We can classify each symptom in one of 6 General Functions and we can determine the
CAUSE of all disturbances from their relationship.
V. THE FUNCTIONAL EVALUATION OF YIN AND YANG
Each of the GENERAL FUNCTIONS possesses 2 Basic Functions or 2 opposite

actions:
YANG stimulates the function.
YIN inhibits the function.
Having checked the balance of the General Functions and having found the Causal
Function, we have to establish whether the cause is YIN or YANG or both
simultaneously.
There are two possible states: EMPTYNESS or FULLNESS:
EMPTYNESS or deficiency of YANG or YIN: XU state. FULLNESS or excess of YANG

or YIN: SHI state.
We can diagnose EMPTYNESS or FULLNESS States by 4 criteria:
EMPTY FULL
Disease CHRONIC ACUTE
Disease INTERNAL EXTERNAL
General State BAD CONDITION
Pulse DEEP SUPERFICIAL
The Functional Evaluation in Traditional Oriental Medicine helps us to understand the

patient‘s general condition by:
- The state of the 6 Vital Substances.
- The Dysfunction of the systems and Meridians.
The Functional Evaluation guides us to the elaboration of treatments.

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B. THE FUNCTIONAL EVALUATION OF THE 6 VITAL SUBSTANCES.
The 6 vital substances are 6 Sources of Life, the 6 ROOTS of THE HUMAN TREE.
As a gardener takes care of the roots if his trees, the doctor should always know the
state of the 6 Roots of the Human Tree, that is to say the state of the 6 Vital
Substances. He has to know the method in order to strengthen them.
I. JING: THE RENAL HORMONES
The Urogenital System produces various hormones. Each of them has very important
functions:
1. The STRUCTURE of the URO-GENITAL SYSTEM and the HORMONES
2. The FUNCTIONS of the URO-GENITAL SYSTEM
a. Reproduction
b. Development
Blood – Bones – Muscles – Hair – Teeth
Memory – Will – Intelligence – Wisdom
c. Stabilization of Body Fluids
d. Stabilization of Temperature
e. Defense of the body, body resistance
f. Anti-stress
3. THE SYMPTOMS OF DEFICIENCY OF THE ROOT JING
a. Chronic Diseases
b. Lower back pain
c. Age
d. Deficiency of sexual activity
e. Deficiency of reproduction
f. Deficiency of the urinary function
g. Deficiency of Development
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Bone – Muscle – Hair – Teeth – Memory
h. Anemia
i. State of stress psycho-physical: cold, heat, fear.
II. XUE – MÁU – BLOOD
There are 3 Sources of Production of the BLOOD:
 Original Digestive BLOOD

 Original Renal BLOOD
 Original Respiratory BLOOD
1. The structure of the digestive system: liver, stomach, gall bladder, small intestine,
large intestine ……
2. The functions of the digestive system for the production of blood
a. Nutrition by the numerous constituents of blood
Plasma: vitamins, electrolytes, amino acids, water
Digestive enzymes
Coagulation factors: prothrombin, Vit K….
b. Support of mental activity
c. Support of QI
3. The symptoms of deficiency of the XUE ROOT (MÁU)
a. Anemia
b. Digestive or kidney or respiratory disorders
c. Bleeding
d. Fatigue
e. Psycho somatic decline
III. QI – ENERGY – KHÍ
1. Definition: QI in Chinese has several meanings:
a. Philosophy: QI is LIFE
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b. Chemistry: QI is air, O2
c. Physics: QI is Energy
d. Medicine: QI is/are the Functions
2. The structure of the respiratory system: lungs, bronchi, trachea, ….
3. The symptoms of deficiency of the QI ROOT
a. Fatigue
b. Passivity
IV. QI – PHYSICAL STRENGTH – KHÍ
The physical strength is one of the manifestations of the Energy QI in various activities
and various daily movements.
The EXTERNAL STRENGTH is linked to the MUSCULO SKELETAL SYSTEM: Live –

GB.
The internal strength is linked to other internal systems.
1. Muscle structure
a. Striated muscles: muscles of the Musculo Skeletal System.
b. Smooth Muscles: muscles of the internal organs.
2. The function of muscle
Muscles use stored energy to create the motion in the systems.
3. Deficiency symptoms of the QI EOOR (KHÍ)
a. Muscle Fatigue
b. Muscle Weakness
c. Passivity
d. Muscle Paralysis
e. When movement: palpitation, tachycardia, tachypnea.
f. At rest: hypotension
V. SHEN – THE MIND – THẦN
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1. Structure of the SHEN ROOT
a. The Central Nervous System
b. The thyroid gland
c. The circulatory system
2. THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM
a. Consciousness directs all activities
b. The symptoms of deficiency of the SHEN ROOT (THẦN)
a. Passivity, Pessimism
b. Decreased intelligence and memory
c. Lock of will
d. Bad feelings: Fear, Anxiety, Sadness, Anger
e. Insomnia‘
f. Neuro-vegetative disorders
VI. JIN YE – TÂN DỊCH
1. The composition of organic liquids
Body fluid makes up 35 liters for a man of 54 kg: 4 to 5 liters of blood + 6 to 10 liters of
lymph + 20 liters of extra cellular fluids and intracellular fluids.
The autonomous nervous system is linked to the production of JIN YE.
2. The functions of the autonomous nervous system
The Autonomous NS controls all Internal Systems:
Organic liquids depend directly on the contribution of food and drinks in the Digestive
System and of secretions of all the other Systems.
3. The symptoms of deficiency of the ROOT JIN YE (TÂN DỊCH)
a. Hyper-excretion: urine, stools, sweat…
b. Weight Loss
c. Dry skin, mouth…
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d. Thirst
VII. CONCLUSION
The 6 ROOTS or 6 VITAL SUBSTANCES play a very important role in the development
of our body.
The 6 ROOTS stimulate our health, our VITALITY and also stimulate the body‘s
defenses against pathological factors.
Each practitioner must be familiar with the role of each root, its functions, deficiency
symptoms, and their treatment to support them.
C. THE FUNCTIONAL EVALUATION OF SYSTEMS AND MERIDIANS
The Second Question of the Functional Evaluation: ― What is the condition of the 12
branches of the Human Tree of Life‖?
I. The Functional Evaluation of the systems
Each of the 6 anatomical – physiological Systems of the Traditional Medicine has two
basic, fundamental functions (YIN and YANG). We can compare these Traditional
Systems with those described in Modern Medicine:
Respiratory System Lung – Large Intestine
Central Nervous System Heart – Small Intestine
Autonomous Nervous System Pericardium – Triple Burner
Digestive System Spleen – Stomach
Articulo – Muscular System Liver – Gall Bladder
Uro-genital System Kidney - Bladder
Each system contains several organs and the symptoms of an Organ are also the
symptoms of its system.
1. Lung – Large Intestine or
Symptoms and diseases of the Respiratory system and skin:
 Cough, asthma, bronchitis, pneumonia

 Rhinitis, epistaxis
 Tonsillitis, laryngitis
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 Allergy, urticaria
2. Heart – Small Intestine or
Symptoms and diseases of the Central Nervous and Circulatory System:
 Insomnia, anxiety, fear.

 Memory loss, diminished intelligence
 Loss of will, hysteria
 Heart diseases, hypertension
 Cerebrovascular diseases
3. Pericardium – Triple Burner or
Symptoms and diseases of the Autonomous Nervous System:
 Symptoms of smooth muscles

 Neuro-vegetative disorders: vasoconstriction, vasodilation
4. Spleen – Stomach or
Symptoms and diseases of the Digestive System:
Gastrointestinal disorders: hepatitis,
5. Liver – gallbladder or
Symptoms and diseases of the Musculo Skeletal system:
 Rheumatism: polyarthritis, myalgia, paralysis, contractures

 Epilepsy, convulsions
 High blood pressure
6. Kidney – Bladder or
Symptoms and diseases of the Uro-Genital System:
 Spermatorrhoea, impotence, premature ejaculation

 Leucorrhoea, menstrual disorders, menopause, prolapse
 Lower back pain, osteoporosis
 Polyuria, nocturia, incontinence, urinary problems
II. THE FUNCTIONAL EVALUATIONOF THE 12 MERIDIANS
The System of the functions is a large system consisting of several Small systems.
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The Small Systems of the Large System are gathered in the System of Meridians.
Accordingly, the Functional Evaluation (FE) of the system of functions is also the FE of
the System of Meridians.
The 12 Meridians are 12 energy routes enabling communication of the System with the
outside world.
The disorders of FUNCTIONS (internal Systems) can show themselves at the level of
their meridians and the disturbances of Meridians can indicate the secret disorders of
the internal Systems.
THE FUNCTIONAL EVALUATION (FE) of meridians is based on:
Symptoms along the path of Meridians: pain, tension, tingling, heat, cold
Pain in the Alarm Points: MO, SHU...
1. The FE of the Meridians by ALARM POINTS:
You must press the alarm points with one finger. If the patient feels pain, this indicates
that the Meridian, corresponding to the alarm point, is disturbed.
Any sensitive point on the meridian path is also considered as alarm point.
2. Points MO and SHU Points.
FUNCTIONS MO SHU OTHERS

LUNG 1 Lu 13 Bl
PERICARDIUM 17 RM 14 Bl 1 Pe
HEART 14 RM 15Bl 1H
STOMACH 12 RM 21 Bl 4 St – 6 St
LARGE INTESTINE 25 St 25 Bl 11 Li – 15 Li
TRIPLE BURNER 5-7 RM 22 Bl
SMALL INTESTINE 4 RM 27 Bl
BLADDER 3 RM 28 Bl 2 Bl -10 Bl
KIDNEY 25 Gb 23 Bl
SPLEEN 13 Liv 20 Bl
LIVER 14 Liv 18 Bl
GALL BLADDER 23 Gb 19 Bl 20 Gb – 30 Gb
III. CONCLUSION
The FE of FUNCTIONS is the FE of the 6 major systems.
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All the functions are identified by their meridians. Thus, the FE of the SYSTEMS is
confirmed by the FE of the Meridians.
D. THE FE OF THE 6 GENERAL FUNCTIONS
I. The functional evaluation of the 6 general functions
1. The 6 elements:
WOOD – FIRE – METAL – WATER – SOURCE
2. 6 functions:
Source, accumulation, motor, thermal, secretory, absorption
3. The symptoms of the 6 general functions:
a. Symptoms of the motor function: it concerns all categories of muscles:

smooth, cardiac, joint muscle.
WOOD increased WOOD decreased
- activity - Passivity
- contraction - Relaxation
- increased peristalsis - decreased peristalsis
- increased toning - toning reduced
- muscle hypertrophy - muscle hypotrophy
- spastic paralysis - flaccid paralysis
- convulsion - prolapse
- tetany - muscle fatigue
- pulse: tightened (XIAN) - pulse: weak (XU)
b. Symptoms of the thermal function: function that produces body heat:

Metabolism.
FIRE increased FIRE decreased
- Sensation of heat - Sensation of freshness
- Red color - Pale color
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- Fever
- Inflammation
- Infection
- Pain
- Bleeding
c. Symptoms of secretory function: a function of all the glands and all organs.
EARTH increased EARTH decreased
Excreta increased excreta reduced
- Sweat
- Urine
- Saliva
- Tears
- Diarrhea - Constipation
- Leucorrhoea - Edema
- Spermatorrhoea
d. Symptoms of the absorption function:
Function of absorption in organs.
METAL increased METAL decreased
Increased absorption Decreased

absorption
- Digestive
- Constipation - Diarrhea
- Very good appetite - Meteorism
- Respiratory
- Deep breathing - Superficial breathing
- Renal
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- Anuria - Polyuria
- Nocturia
e. Symptoms of the accumulation function:
Function of storage in organs and cells.
WATER increased WATER decreased
- Increased body weight - Loss of body weight
- Sensation of warmth - sensation of cold
- Vaso-dilation - Vaso – constriction
- Pale skin - Wan skin
- Stubborn person
4. The functional evaluation of the 6 general functions:
We can classify each of the symptoms found in one of the 6 General Functions.
Knowing the relationship of Stimulation and Inhibition of 6 functions, we can determine

the causal function of the disturbances.
There are two disturbances for each function:
 Either it is INCREASED
 Or it is DECREASED
There are 6 general functions which means that there are12 possible CAUSES of
Disturbance of the 6 Movements. The Movement is either increased or decreased and
this possibillity exists for the 6 functions.
II. THE FUNCTIONAL VALUATION OF YIN – YANG FOR THE 6 GENERAL

FUNCTIONS
YIN and YANG are two opposite actions: Stimulation and Inhibition of all things and
phenomena.
So, every General Function has two aspects, one is YIN and the other is YANG.
1. The state of Deficiency of YIN and YANG
The Deficiency or Emptiness of YANG:
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YANG does not stimulate the General Function and the result will be a reduced General
Function.
The Dediciency or Emptiness of YIN:
YIN does not inhibit the General Function and the result will be an increased General
Function.
2. The State of EXCESS of YIN or YANG:
The excess or fullness of YANG:
YANG will stimulate the General Function and the result will be an increased General
Function.
The excess or fullness of YIN:
YIN will inhibit the General Function and the result will be a reduced General Function.
3. Some examples:
If YANG FIRE is increased, we will talk about EXCESS of YANG.
If YIN FIRE is reduced, we will talk about YIN DEFICIENCY.
We can also find simultaneously: YANG FIRE increased and YIN FIRE decreased.
If YANG WATER is reduced, we will talk about DEFICIENCY Of YANG.
If YANG WATER is increased, we will talk about EXCESS of YIN.
We can also find simultaneously: YANG WATER decreased and YIN WATER
increased.
III. CONCLUSION
The state of the 6 leaves of the Human Tree of Life corresponds to the evaluation of the
6 GENERAL FUNCTIONS and the MAIN CAUSE.
The State of 2 Faces of the Leaf corresponds to the Evaluation of EXCESS or

DEFICIENCY of YIN or YANG of the main causal FUNCTION.
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PRACTICE
I. Write the nouns and the meanings of the following verbs in the table below.
Number Verbs Nouns Meanings
1 Coagulate
2 Stabilize
3 Reproduce
4 Develop
5 Evaluate
6 Treat
7 Palpate
8 Examine
9 Discover
10 Possess
II. Choose the best answer to complete each of the following sentences.
1. Functional Balance is very important especially in the case of __________ diseases

or poor general condition of the patient.
A. acute B. chronic C. infectious D. congenital
2. Each of the 6 systems contains a number of functions. The symptoms of the

functions are also __________ of their systems.
A. symptoms B. signs C. syndromes D. features
3. We can classify each symptom in one of 6 general functions and we can determine
the __________ of all disturbances from their relationship.
A. characteristic B. manifestation C. indication D. cause
4. The Functional Evaluation in Traditional Oriental Medicine helps us to understand the

patient‘s __________ condition.
A. specific B. special C. general D. local
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5. The Functional Evaluation guides us to the elaboration of __________.
A. diagnoses B. treatments C. analyses D. syntheses
6. There are 3 sources of production of the blood: original __________ blood, original
__________ blood and original __________ blood.
A. digestive/ renal / respiratory B. digestive / renal/ subcutaneous
C. digestive / circulatory / respiratory D. urogenital / renal / respiratory
7. The physical strength is one of the __________ of the Energy QI in various activities
and various daily movements.
A. symptoms B. signs C. manifestations D. syndromes
8. Body fluid makes up 35 liters for a man of 54 kg: 4 to 5 liters of blood, 6 to 10 liters of
lymph , 20 liters of extra __________ fluids and __________ fluids.
A. epithelial / intracellular B. cellular /intracellular
C. cellular / visceral D. epithelial / visceral
9. __________ liquids depend directly on the contribution of food and drinks in the
digestive system and of __________ of all the other systems.
A. Organic / excretions B. Inorganic / secretions
C. Inorganic / excretions D. Organic/ secretions
10. The 6 __________ or 6 vital substances play a very important role in the
development of our body.
A. roots B. branches C. leaves D. faces
III. Find and correct the mistake in each of the following sentences.
1. The 6 ROOTS stimulate our health, our vitality and also stimulates the body‘s
A B
defenses against pathological factors.
C D
2. Each practitioner must be familiar with the role of each root, their functions, deficiency
A B C
symptoms, and their treatment to support them.
D
3. Each the 6 anatomical – physiological systems of the Traditional Medicine has two
A B C
basic, fundamental functions (YIN and YANG).
D
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4. Each system contains several organs and the symptoms of an organ is also the
A B C
symptoms of its system.
D
5. The 12 Meridians are 12 energy routes enable communication of the system with the
A B C
outside world.
D
6. The disorders of functions (Internal Systems) can show itself at the level of their
A B
meridians and the disturbances of Meridians can indicate the secret disorders of the
C D
internal systems.
7. You must press the alarm points with one finger. If the patient feels pain, this
A B C
indicates that the Meridian, corresponds to the alarm point, is disturbed.
D
8. All the functions identify by their meridians. Thus, the FE of the systems is confirmed
A B C D
by the FE of the Meridians.
9. We can classify each of the symptoms to find in one of the 6 General Functions.
A B C D
10. There are 6 general functions which means that there are12 possible causes of
A B C
Disturbance of the 6 Movements. The Movement is either increased and decreased and
D
this possibility exists for the 6 functions.
IV. Give the right form of the words in brackets to complete the following
sentences.
1. YIN and YANG are two opposite actions: Stimulation and __________ of all things
and phenomena. (inhibit)
2. The Deficiency or Emptiness of YANG: YANG does not __________ the General
Function and the result will be a reduced General Function. (stimulation)
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3. The __________ or Emptiness of YIN: YIN does not inhibit the General Function and
the result will be an increased General Function. (deficient)
4. The excess or fullness of YANG: YANG will stimulate the General Function and the
result will be an __________ General Function. (increase)
5. The excess or fullness of YIN: YIN will inhibit the General Function and the result will
be a __________ General Function. (reduce)
6. The state of the 6 leaves of the Human Tree of Life corresponds to the __________
of the 6 GENERAL FUNCTIONS and the MAIN CAUSE. (evaluate)
7. Every __________ Function has two aspects, one is YIN and the other is YANG.
(generally)
8. The examination in Modern Medicine __________ diseases and allows to estimate

the treatment effects of Traditional Medicine. (confirmation)
9. The examination in Traditional Medicine guides the practitioner in the __________ of

treatment options. (elaborate)
10. The purpose of the __________ Evaluation is primarily to answer 4 questions.

(function)
V. Complete the following passage using the words given in the box.
to remained technology healthcare message
early experience knowledge acupuncture concept
With over 3000 years of (1) __________, Traditional Chinese Medicine (TCM) has (2)
__________ one of the many fascinating areas in ancient Chinese culture. First known
to be documented in the Yellow Emperor's Canon of Medicine, TCM is believed to have
been practised in as (3) __________ as 475 to 221 B.C. The field of working (4)
__________ of TCM stretches from anything related to general (5) __________ practice
to the philosophy of the mind, the logic of life, religion, and even to as far as cosmology
and astronumerology. This is why in order (6) __________ thoroughly understand the
concepts behind TCM, one must be comprehensive in learning and embracing the
Chinese culture as a whole.
Just as Douglas Hoff put it when he explained about (7) __________, "The systems of
TCM uses the concepts of elements and meridians and are completely immersed in the
Asian cosmology which takes shape through the religions." The meridian-brain
mechanism, the fundamental working (8) __________ of acupuncture, in which the pain
block from the (9) __________ that the needle or burning cone of herbs gives to the
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point of stimulus, was only found centuries later by the West through science and (10)
__________.
VI. Translate the following passage into Vietnamese
The Five Elements Theory
The Five Elements theory posits wood, fire, earth, metal, and water as the basic
elements of the material world. These elements are in constant movement and change.
Moreover, the complex connections between material objects are explained through the
relationship of interdependence and mutual restraint that governs the five elements. In
traditional Chinese medicine Five Elements theory is used to interpret the relationship
between the physiology and pathology of the human body and the natural environment.
The Categorization of Things
The ancient physicians used the Five Elements theory to study extensively the
connections between the physiology and pathology of the zang-fu organs and tissues
and the natural environment. By adopting the methodology of "comparing similarity to
expose phenomenon," the ancient Chinese attributed different phenomena to the
categories of the five elements. On the basis of the phenomena's different
characteristics, functions, and forms, the complex links between physiology and
pathology as well as the correlation between the human body and the natural
environment were explained.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
VII. Read the reading passage and answer the questions.
For millennia, people have healed with herbal or animal-derived remedies, using
knowledge handed down through generations.
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In Africa, Asia, Latin America and the Middle East, 70-95 per cent of the population still
use traditional medicine (TM) for primary healthcare. And some 100 million people are
believed to use traditional, complementary or herbal medicine in the European Union
(EU) alone — as high as 90 per cent of the population in some countries.
The industry is worth big money. In 2012, global sales of Chinese herbal medicine
reached US$83 billion, up more than 20 per cent from 2011. The global market for all
herbal supplements and remedies could reach US$115 billion by 2020, with Europe the
largest and the Asia-Pacific the fastest growing markets. The demand is driven by
women as the main consumers of dietary supplements, by growing emphasis on
healthy living and concerns over the side-effects of mainstream drugs.
Questions
1. What have happened for millennia?
______________________________________________________________________
______________________________________________________________________
2. Where in the world do most of the population still use traditional medicine (TM) for
primary healthcare?
______________________________________________________________________
______________________________________________________________________
3. What are people believed to use in the European Union?
______________________________________________________________________
______________________________________________________________________
4. According to the passage, when did global sales of Chinese herbal medicine reach
US$83 billion?
______________________________________________________________________
______________________________________________________________________
5. What may happen by 2020?
______________________________________________________________________
______________________________________________________________________
VIII. Make sentences using the verbs or nouns in the table above.
1. __________________________________________________________________________
2. __________________________________________________________________________
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3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
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UNIT
BASIC CONCEPT
2
A. Yin – yang
The theory of yin-yang originated in antiquity in China. It is a theory dealing with the
origination of the universe as well as the motion and variation of all things in the natural
world. It holds that the natural world is made up of materials and that the material world
conceives, develops and constantly varies under the interaction of yin and yang. The
philosophers and doctors in ancient China explained all the phenomena and the nature
of the universe and life with the theory of yin-yang. They regarded the opposition, the
wane and wax as well as the variation of yin- yang as ― the law of the universe‖.
I. The implication of yin-yang and the categorization of things according to the

nature of yin-yang
People in ancient China held that the original state of the universe was ―qi‖ and that the
motion and variation of ―qi‖ produced two poles known as ―yin‖ and ―yang‖. Such a
process of transformation was called ― to divide one into two‖. Since all the things in the
universe are produced through the motion and variation of qi, everything can be divided
into the aspects of yin and yang, such as the heaven and the earth, the day and the
night, the water and fire, upper and lower, cold and heat as well as man and woman,
etc.
1. The implication of yin-yang
The original meaning of yin and yang is simple and specific, mainly referring to the sides
facing and opposite to the sun. That is to say that the things facing the sun pertain to
yang while the things opposite to the sun pertain to yin. In Chinese, ― yang‖ means
―sunshine‖ while ― yin‖ means ― shadow‖. Later on specific things related to yin and yang
were abstracted to induce a series of properties in the light of yin and yang. In this way,
yin and yang, two special signifiers, gradually evolved into a theory of extensive
application. Consequently the implication of yin and yang was extended.
The properties of things signified by yin and yang are quite abstract. In order to make
the meaning of yin and yang explicit, people in ancient China used specific things,
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namely water and fire, as metaphors to analogize. Since water and fire are opposite to
each other in nature and reflect the basic characteristics of yin and yang in Huangdi
Neijing. Comparatively speaking, fire is warm, bright, active and up-flaming; while water
is cold, dim, static and downward-moving. That is why it is stipulated in Huang-di Neijing
that ― water is yin and fire is yang‖.
2. The categorization of things according to yin and yang.
Fire and water are the evidences used to categorize things because they are the
signifiers of yin and yang. Generally speaking, the things and the phenomena that bear
the properties of being warm, bright, active, rising and dispersing pertain to yang; while
the things and the phenomena that bear the properties of being cold, dim, static,
descending and astringing pertain to yin.
According to such criteria, all things and phenomena can be categorized into either yin
or yang group. However, the yin and yang properties of things are relative, not absolute.
In the categorization of things according to the nature of yin and yang, two points have
to be taken into consideration.
(1) The yin or yang properties of things may vary with the change of time and
application. Take spring and summer for example. It is comparatively hot in summer
and cold in spring, so summer pertains to yang and spring to yin. Take spring and
winter for another example. It is comparatively cold in winter and warm in spring, so
winter pertains to yin while spring to yang.
(2) Any aspect of yin and yang in an object can be further and infinitely divided. In this
case there exists yin within yang and yang within yin. Take daytime and night for
example. Daytime pertains to yang while night to yin. However, daytime can be
further divided into two phases; morning and afternoon. Since yang-qi ascends in
the morning and descends in the afternoon, morning pertains to yang (yang within
yang) and afternoon to yin (yin within yang). Similarly, night can be divided into
anterior night and posterior night. Since yin-qi increases in the anterior night and
decreases in the posterior night, anterior night pertains to yin (yin within yin) while
posterior night to yang (yang within yin).
II. Interaction between yin and yang
The yin and yang aspects within an object or phenomenon are not simply arbitrary
divisions. In fact they are in constant and complicated interaction. Such interactions
between yin and yang give rise to the origination, development and change of things.
23
The interactions between yin and yang are various in manifestations. The following is a
brief description of the major ones.
Opposition of yin and yang
Since yin and yang are opposite to each other in nature, they constantly repel and
restrain each other. If both yin and yang are quite powerful, such a mutual repeling and
restraining activity will maintain general equilibrium of things. If one side is weak and the
other side is strong, the strong side will restrain the weak side, consequently damaging
the general balance of things. The so-called ―contrary treatment‖, one of the basic
therapeutic principles in TCM, is developed in the light of the opposition between yin
and yang. For example, the treatment of cold disease with drugs hot in nature means to
use heat (yang) to control cold (yin) while the treatment of febrile disease with drugs
cold in nature means to use cold drugs (yin) to restrict heat (yang). Since the drugs
used and the disease treated are different in nature, such a treatment is termed
―contrary treatment‖. ―Contrary‖ means ―opposite‖.
Interdependence between yin and yang
Interdependence between yin and yang, literarily yin and yang rooting in each other,
indicates that yin and yang depend on each other for existence in an object. In
conception, yin and yang must exist in pair and no side can exist solitarily. In nature, yin
and yang within an object can transform into each other under certain condition,
implying that no one can exist without the existence of the other. That is why it is said in
the theory of TCM that ―solitary yang cannot exist‖ and ― solitary yin cannot grow‖. In the
light of interdependence between yin and yang, TCM pays much attention to mutual
transformation between qi and blood as well as yin and yang in the treatment of disease
due to deficiency of qi and blood as well as of yin and yang. For example, the patients
with blood deficiency can be treated by supplementing blood to promote qi, the patients
with yin deficiency can be treated by supplementing yin to promote yang (also called
―drawing yang from yin‖).
Wane and wax between yin and yang
Wane and wax between yin and yang implies that in the interaction between yin and
yang, one side is developing while the other side is declining and vice versa. Such a
state manifests in different ways, such as yin waning while yang waxing, yin waxing
while yang waning, yang waning leading to yin waxing, and yang waxing leading to yin
waning.
Under normal condition, wane and wax between yin and yang are maintained to a
certain range. Waning to a certain degree will turn to waxing and waxing to a certain
level will change into waning. In this way wane and wax will never be excessive.
24
Alternation and repetition of wane and wax maintain a dynamic balance between yin
and yang.
If wane and wax between yin and yang exceeds the normal level, relative predominance
or relative decline of either yin and yang will arise, consequenly damaging the dynamic
balance between yin and yang and leading to imbalance of yin and yang.
Mutual transformation between yin and yang
If yin or yang wanes or waxes to the extreme point, it will turn to the opposite. This
means yin will change into yang and yang into yin. The key element involved in such a
mutual transformation is the degree of wane and wax. The degree that leads to
transformation is termed ―extreme point‖ or ―excess‖ in TCM. In Huangdi Neijing, it
suggests that ―extreme cold generates heat‖, ―extreme heat generates cold‖, ―excessive
yin turns into yang‖ and ―excessive yang changes into yin‖, all reflecting mutual
transformation relationship between yin and yang.
The typical mutual transformation process of yin and yang is well signified by the
variations of yin and yang in the four seasons of a year. From spring to summer, yang
waxes while in wanes. However when such a transformation reaches the peak – the
Summer Solstice, yin begins to wax while yang starts to wane. Such a change exactly
explains the idea that ― excessive yin turns into yang‖ and ― excessive yang changes
into yin‖. With the wane and wax of yin and yang, cold and heat in the climate also
alternate. Such an alternation vididly demonstrates the theory that ―extreme cold
generates heat‘ and ―extreme heat generates cold‖.
III. FIVE PHASES
wood – fire – earth (soil) – metal – water
1. Five – phase interactions
Engendering: the nurturing effect that the five phases and their corresponding
phenomena have on each other. Wood (liver) engenders fire; fire (heat) engenders
earth; earth (spleen) engenders metal; metal (lung) engenders water; water (kidney)
engenders wood. Engendering thus follows teh sequence wood  fire  earth  metal
 water  wood. It reflects the way in which spring gives way to summer, summer
gives way to long summer, etc.
Restraining: the action of the five phases and their corresponding phenomena of
keeping each other in check. Wood (liver) restrains earth; earth (spleen) restrains water;
water (kidney) restrains fire; fire (heart) restrains metal; metal (lung) restrains wood.
Restraining thus follows the sequence wood  earth  water  fire  metal  wood.
25
When the restraining cycle breaks down, the resulting disharmonies are called rebellion
or overwhelming.
Rebellion: in the doctrine of the five phases, a reversal of the restraining relationship,
where one of the five phases, a reversal of the restraining relationship, where one of the
five phases is disproprotinately strong and rebels against the phase that should
normally restrain it. For example, wood is normally restrained by metal, but if wood
becomes too strong it will rebel against metal.
Powerless to withstand the attack, metal will succumb. In terms of the bowels and
viscera, this means that when the liver, normally restrained by the lung, becomes too
strong, it will rebel against the lung and overcome it.
Overwhelming: in the doctrine of the five phases, an abnormal exaggeration of

restraining where one of the five phases is weakened and causes the phase that under
normal circumstances would overcome it to invade and weaken it further. For example,
wood normally restrains earth, but if earth is weak, then wood overwhelms it, rendering
earth even weaker. In terms of the viscera, this means that the spleen, which the liver
normally restrains, will, if weak, be completely overwhelmed by the liver and become
even weaker.
2. Five – phase explanation of relationship between viscera
Wood fire tormenting metal: liver fire affecting the lung. Wood in the five phases is the
liver, and metal is the lung. When liver fire becomes excessively effulgent, it can scorch
lung yin and cause dry cough, chest and rib-side pain, heart vexation, bitter taste in the
heart, red eyes, and in severe cases, expectoration of blood. This is the manifestation of
wood fire tormenting metal.
Depressed wood transformating into fire: depressed liver qi that gives rise to fire
signs such as red face, red eyes, headache, dizziness, vomiting and retching, coughing
of blood, and , in severe cases, mania. ―Wood‖ in this context means the liver according
to the five-phase understanding that the liver belongs to wood. However, ―fire‖ means
fire as an evil, not the viscus that belongs to fire, which is the heart.
Fire and water help each other: heart fire and kidney water balance each other. In the
doctrine of the five phases, the heart belongs to fire and the kidney belongs to water,
and each restrains the other.
Depleted water and effulgent fire: 1. Insufficiency of kidney-water that causes

effulgent heart fire, characterized by heart vexation, dizziness, insomnia or unquiet
sleep, red-tipped tongue, and a rapid fine pulse. 2. A yin-yang imbalance of the kidney
characterized by yin vacuity and yang hyperactivity. 3. Kidney yin depletion with
26
hyperactivity of the life gate fire, characterized by loosening of and pain in the teeth,
excessive libido, and seminal emission.
Fire failing to engender earth: kidney yang failing to warm the spleen. Earth
represents the spleen, whereas fire represents kidney yang (not the heart). In kidney
yang vacuity (insufficiency of the life gate fire), the spleen is deprived of warmth and its
ability to transform food and water-damp is affected. Hence, there are signs of spleen-
kidney yang vacuity such as cold limp lumbus and knees, nontransformation of food,
inhibited urination, swelling, and fifth-watch diarrhea.
Five viscera
Liver: belongs to wood
Heart: belongs to fire
Spleen: belongs to earth (soil)
Lung: belongs to metal
Kidney: belongs to water
Governings of the five viscera
Sinew: tough, stringy, elastic parts of the body (tendon, muscle). Governed by liver.
Vessel: Governed by the heart
Flesh: Governed by the spleen
Skin and (body) hair: Governed by the lung
Bone: Governed by the kidney
Five offices
Eye: Governed by the liver
Tongue: Governed by the heart
Lips: Governed by the spleen
Nose: Governed by the lung
Ear: Governed by the kidney
27
Five colors
Green-blue: color associated with wood
Red: color associated with fire
Yellow: color associated with earth (soil)
White: color associated with metal
Black: color associated with water
Five humors
Tears: humor of the liver
Sweat: humor of the heart
Drool: humor of the spleen. Drool is said to spring from the cheeks and to flow out from
the corners of the mouth during sleep.
Snivel; nasal mucus: humor of the lung
Spittle: humor of the kidney. Spittle is said to spring from under the tongue and to be
spat out of the mouth.
Five flavors
Sour, sourness: flavor associated with wood
Bitter, bitterness: flavor associated with fire
Sweet, sweetness: flavor associated with earth (soil)
Acrid, acridity: flavor associated with metal
Salty, saltiness: flavor associated with water
Five minds
Anger: mind associated with liver-wood
Joy: mind associated with heart-fire
Thought: mind associated with spleen-earth
Anxiety: mind associated with lung-metal
Fear: mind associated with kidney-water
28
Seven affects: the seven affects are an alternative classification of mental states. They
comprise the five minds given above, sorrow, and fright. Note that the affects and minds
are often referred to generically as ―affect-mind‖
PRACTICE

1 produce
2 explain
3 interact
4 originate
5 divide
6 Imply
7 Relate
8 Transform
9 Indicate
10 Promote
1. The theory of yin-yang is a theory dealing with the origination of the universe as well
as the __________ and __________ of all things in the natural world.
A. motion / variety B. motion / variation
C. formation / variation C. formation / variety
2. The philosophers __________ and doctors in ancient China explained all the
phenomena and the nature of the universe and life with the theory of yin-yang.
A. philosophers B. physiologists C. psychologists D. psychiatrists
3. People in ancient China held that the original state of the universe was ―qi‖ and that
the motion and variation of ―qi‖ produced two poles __________ ―yin‖ and ―yang‖.
A. known B. called as C. known as D. defined
4. In order to make the meaning of yin and yang explicit, people in ancient China used
specific things, namely __________, as metaphors to analogize.
A. wood and fire B. water and air
C. wood and water D. water and fire
29
5. __________ yin and yang are opposite to each other in nature, they constantly repel
and restrain each other.
A. Because B. Although C. Since D. Both A and C
6. __________ between yin and yang, literarily yin and yang rooting in each other,
indicates that yin and yang depend on each other for existence in an object.
A. Interdependence B. Independence
C. Dependence D. None is correct.
7. __________between yin and yang implies that in the interaction between yin and
yang, one side is developing while the other side is declining and vice versa.
A. Sunshine and shadow B. Wane and wax
C. Water and fire D. Daytime and night-time
8. If yin or yang wanes or waxes to the extreme point, it will turn to the __________.
This means yin will change into yang and yang into yin.
A. opposite B. contrast C. antonym D. synonym
9. Fire and water help each other: heart fire and kidney water __________ each other.
A. stability B. instability C. imbalance D. balance
10. __________ and repetition of wane and wax maintain a dynamic balance between
yin and yang.
A. Alteration B. Alternation C. Adaptation D. Adoption
1. The theory of yin-yang holds that the natural world is made up materials and that the
A B C
material world conceives, develops and constantly varies under the interaction of yin
D
and yang.
2. Fire and water are the evidences used to categorizing things because they are the
A B C
signifiers of yin and yang.
D
3. The patients with blood deficiency can be treated by supplementing blood promoting
A B C D
qi, the patients with yin deficiency can be treated by supplementing yin to promote yang.
30
4. Under normal condition, wane and wax between yin and yang are maintained by a
A B C D
certain range.
5. Since all the things in the universe produced through the motion and variation of qi,
A B
everything can be divided into the aspects of yin and yang, such as the heaven and the
C D
earth, the day and the night, the water and fire, upper and lower, cold and heat as well
as man and woman, etc.
6. In the doctrine of the five phases, the heart belongs to fire and the kidney belongs to
A B
water, and each restrains another.
C D
7. The typical mutual transformation process of yin and yang well signifies by the
A B C
variations of yin and yang in the four seasons of a year.
D
8. If wane and wax between yin and yang exceeded the normal level, relative
A B C
predominance or relative decline of either yin and yang will arise.
D
9. Alternation and repetition of wane and wax maintains a dynamic balance between yin
A B C D
and yang.
10. In nature, yin and yang within an object can transform into one another under
A B
certain condition, implying that no one can exist without the existence of the other.
C D
sentences.
1. The original meaning of yin and yang is simple and specific, __________ referring to
the sides facing and opposite to the sun. (main)
2. In Chinese, ― yang‖ means ―sunshine‖ while ― yin‖ means ― shadow‖. Later on specific
things related to yin and yang were __________ to induce a series of properties in the
light of yin and yang. (abstract)
31
3. The yin and yang aspects within an object or phenomenon are not simply arbitrary
__________. In fact they are in constant and complicated interaction. (divide)
4. The typical mutual __________ process of yin and yang is well signified by the
variations of yin and yang in the four seasons of a year. (transform)
5. When liver fire becomes excessively effulgent, it can scorch lung yin and cause dry
cough, chest and rib-side pain, heart vexation, bitter taste in the heart, red eyes, and in
severe cases, __________ of blood. (expectorate)
6. Wood is __________ restrained by metal, but if wood becomes too strong it will
rebel against metal. (normal)
7. With the wane and wax of yin and yang, cold and heat in the climate also
__________. (alternative)
8. __________ to a certain degree will turn to waxing and waxing to a certain level will
change into waning. (wane)
9. The interactions between yin and yang are various in __________.(manifest)
10. Since yin-qi increases in the anterior night and __________ in the posterior night,
anterior night pertains to yin (yin within yin) while posterior night to yang (yang within
yin). (decreasing)
Yin and yang
has interact express found on
natural thought forms well philosophy
In Chinese (1) __________ , yin and yang ("dark-bright", "negative-positive") describes

how seemingly opposite or contrary forces may actually be complementary,
interconnected, and interdependent in the (2) __________ world, and how they may
give rise to each other as they interrelate to one another. Many tangible dualities (such
as light and dark, fire and water, expanding and contracting) are (3) __________ of as
physical manifestations of the duality symbolized by yin and yang. This duality lies at
the origins of many branches of classical Chinese science and philosophy, as well as
being a primary guideline of traditional Chinese medicine, and a central principle of
different (4) __________ of Chinese martial arts and exercise, such as baguazhang,
taijiquan (t'ai chi), and qigong (Chi Kung), as (5) __________ as appearing in the
pages of the I Ching.
32
Duality is (6) __________ in many belief systems, but yin and yang are parts of an
oneness that is also equated with the Tao. The term 'dualistic-monism' or dialectical
monism has been coined in an attempt to (7) __________ this fruitful paradox of
simultaneous unity/duality. Yin and yang can be thought of as complementary (rather
than opposing) forces that (8) __________ to form a dynamic system in which the
whole is greater than the assembled parts. According to this philosophy, everything (9)
__________ both yin and yang aspects (for instance, shadow cannot exist without
light). Either of the two major aspects may manifest more strongly in a particular object,
depending (10) __________ the criterion of the observation. The yin yang (i.e. taijitu
symbol) shows a balance between two opposites with a portion of the opposite element
in each section.
Yin Yang Introduction
Yin Yang is perhaps the most known and documented concept used within Taoism.
A starting definition: Yin / Yang: Two halves that together complete wholeness. Yin
and yang are also the starting point for change. When something is whole, by definition,
it‘s unchanging and complete. So when you split something into two halves – yin/yang,
it upsets the equilibrium of wholeness. Both halves are chasing after each other as they
seek a new balance with each other.
The word Yin comes out to mean ―shady side‖ and Yang ―sunny side‖. Yin Yang is the
concept of duality forming a whole. We encounter examples of Yin and Yang every day.
As examples: night (Yin) and day (Yang), female (Yin) and male (Yang). Over
thousands of years, quite a bit has been sorted and grouped under various Yin Yang
classification systems. The symbol for Yin Yang is called the Taijitu. Most people just
call it the yin yang symbol in the west. The taijitu symbol has been found in more than
one culture and over the years has come to represent Taoism.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
33
______________________________________________________________________
______________________________________________________________________
Yin and Yang Relationships
Yin and Yang are universal aspects all things can be classified under, this includes
diseases in general as well as the Eight Principles' first three couples. For example, cold
is identified to be a yin aspect, while heat is attributed to yang. Since descriptions of
patterns in terms of yin and yang lack complexity and clinical practicality, though,
patterns are usually not labelled this way anymore. Exceptions are vacuity-cold and
repletion-heat patterns, who are sometimes referred to as "yin patterns" and "yang
patterns" respectively.
After the fundamental nature of a disease in terms of the Eight Principles is determined,
the investigation focuses on more specific aspects. By evaluating the present signs and
symptoms against the background of typical disharmony patterns of the various entities,
evidence is collected whether or how specific entities are affected. This evaluation can
be done with respect to the meridians, qi, xuě, body fluids and zàng-fǔ. Alternatively, a
less specific is disharmony pattern description in terms of the Five Elements may also
be utilized.
There are also three special pattern diagnosis systems used in case of febrile and
infectious diseases only per the "Six Channel system" or "six division pattern"; "Wei Qi
Ying Xue system" or "four division pattern"; and "San Jiao system" or "three burners
pattern".
Questions
1. What are Yin and Yang?
______________________________________________________________________
______________________________________________________________________
2. Why are patterns usually not labelled this way anymore?
______________________________________________________________________
______________________________________________________________________
3. What exceptions are mentioned in the passage?
______________________________________________________________________
34
______________________________________________________________________
4. When does the investigation focus on more specific aspects?
______________________________________________________________________
______________________________________________________________________
5. What are the other names for the "Six Channel system"; "Wei Qi Ying Xue system"
and "San Jiao system"?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
35
UNIT
THE FIVE ZANG-ORGANS

3
Overview
The five zang-organs include the heart, the lung, the liver, the spleen and the kidney.
The following is a brief description of the physiological functions of the five zang-organs
and the orifices. The latter includes three aspects, i.e. the relationships of the five zang-
organs with the five constituents, the organs that the five zang-organs open into and the
local external manifestations of the five zang-organs.
The five constituents include the vessels, the skin, the tendons, the muscles and the
bones that are dominated by the five zang-organs respectively.
The orifices, simplications for ―the five sensory organs and the nine orifices‘, include the
tongue, the nose, the eyes, the mouth, the ears, the external genitals and the anus. The
heart, lung, the liver and the spleen govern one orifice respectively. But the kidney
opens into the ears, the external genitals and the anus.
The focal external manifestations of the five zang-organs refer to five special areas (i.e.
the face, the body hair, the nails, the lips and the hair) on the surface of the body on
which the essence of the five zang-organs displays.
I. The heart
1. The heart is located in the chest between the two lobes of the lung. The heart
occupies the first place among the five place among the five zang-organs and governs
the life activities of the whole body. That is why it is said that the heart is ― an organ of
monarch‘ in Huangdi Neijing.
2. The physiogogical functions of the heart
The physiogogical functions of the heart are mainly to govern blood and to control the
mind.
a. Governing blood
36
The function of the heart to govern blood means that the heart propels blood to circulate
in the vessels and that the heart is related to the production of blood.
Blood circulates inside the vessels. Since the heart is connected directly with the
vessels, its beat is the motive power to propel blood to flow in the vessels. Thus a
relatively independent blood circulation system is formed with the heart, the vessels and
blood. Only under the propelling of the heart beat and the control of the vessels can
blood normally circulate all through the body, in which the heart beat is key to blood
circulation.
The reason that the heart propels blood to circulate within the vessels lies in the
propelling and warming functions of heart-qi and heart-yang as well as the nourishing
and moistening functions of heart-yin and heart-blood. Sufficiency of heart-qi, heart-
blood, heart-yin and heart-yang guarantee normal beat of the heart and continuous
circulation of blood to nourish all parts of the body, thus maintaining the normal
physiological functions of all tissues and organs with the manifestations of full vitality,
ruddy complexion and normal pulse. However, if heart-qi, heart-blood, heart-yin and
heart-yang are insufficient or in disturbance, the function of the heart to govern the
vessels will be affected, leading to a series of pathological changes such as pale
complexion and thin and weak pulse due to insufficiency of heart-qi as well as cyanotic
complexion and unsmooth pulse or slow pulse with irregular intervals or slow regular
intermittent pulse due to stagnation of heart-blood.
The heart also plays a role in the production of blood, known as ―reddening‖ in TCM.
After digestion and absorption of food by the spleen and stomach, the refined nutrients
are transported up to the heart and the lung. Combined with the fresh air inhaled into
the lung, warmed and steamed by heart-yang, these refined nutrients are transformed
into red blood.
Besides, TCM believes that ―the heart controls blood vessels‖, a combination of the
ideas that ―the heart governs blood‖ and ―the heart controls the vessels‖. The idea that
―the heart controls blood and vessels‖ is described in the section of ―the relationship
between the heart and the body, the sensory organs and the orifices‖.
b. Controlling the mind
The function of the heart to control the mind is also known as ―the heart storing spirit‖. In
a broad sense, spirit refers to the supreme dominator of life activities in the whole body.
In a narrow sense, spirit is a collective term for cognition, thinking, consciousness and
mental states. The idea that the heart controls the mind means that the heart governs
the mental activities.
37
The mental activities are closely related to the response of the brain to the external
environment and certain intrinsic functions of the brain. Centering around the five zang-
organs, TCM attributes the motivation of mental activities to the heart. It is obviously
that the conception of the heart in TCM includes certain function of the brain.
The normal function of the heart to control the mind depends on the nourishing and
moistening functions of heart-blood and heart-yin which are the essential substantial
bases for mental activities. Heart-qi and heart-yang function to activate and stimulate
heart-spirit, which also plays an important role in ensuring the normal function of the
heart to control the mind. If the function of the heart to control the mind is normal,
people will be full of vigor, conscious in mind, agile in thinking and keen in response. If
the function of the heart to control the mind is abnormal due to insufficiency or
disturbance of heart-qi, heart-blood, heart-yin and heart-yang, it will inevitably lead to
palpitation, insomnia, dreaminess, or even coma, delirium and unconsciousness.
II. The lung
1. The lung is located in the chest. Since its location is the highest among the internal
organs, it is compared to a ―canopy‖. The lung is delicate, intolerable to cold and heat,
and is easy to be attached by pathogenic factors. That is why it is called ―a delicate
organ‖.
The function of the lung mainly depends on the propelling and fixating functions of lung-
qi, and secondly, is related to the moistening function of lung-yin. The movement of
lung-qi is characterized by dispersion and descent which are all reflected in the
physiological functions of the lung.
Dispersion means to diffuse, dredge and spread upwards and outwards. Descent
means the downward cleaning and clearing downwards and inwards.
Since the lung assists the heart to promote blood circulation, it is said in Huangdi
Neijing that the lung is an ―assistance – organ‖.
2. The physiological functions of the lung
The main physiological functions of the lung are dominating qi and managing the
regulation of water passage.
a. Dominating qi
The physiological function of the lung to dominate qi covers two aspects: to dominate
respiration and to control qi through out the body.
(1) Dominating respiration: the function of the lung to dominate respiration means
that the lung controls the respiratory movement.
38
The lung is the main organ involved in respiratory movement and the place
where air is in and out of the body exchanges. The body inhales fresh air and
exhales waste air through the respiratory movement of the lung so as to maintain
the normal activities of life.
The normal function of the lung to dominate respiration, apart from the
moistening function of lung-yin, mainly relies on the dispersing and descending
functions of lung-qi. Waste air is exhaled out of the body by means of the
dispersing function of lung-qi and fresh air is inhaled into the body through the
descending function of lung-qi. Thus the dispering function and descending
function of lung-qi depend on each other and restrict each other to maintain the
normal respiratory function of the body. Physiologically, harmonious dispersing
and descending functions of lung-qi ensures smooth and regular respiration. If
lung-qi fails to disperse and descend, it will affect respiration, leading to chest
oppression, cough and dyspnea.
(2) Dominating qi through out the body: the function of the lung to dominate qi all
through the body means that the lung controls and regulates qi in the whole
body. Such a function is reflected in the following three aspects:
The first aspect is the production of the pectoral qi (or thoracic qi). The pectoral
qi, part of qi in the body, is synthesized with the nutrients of food refined by the
spleen and fresh air inhaled by the lung. When it is produced, the pectoral qi is
transported and distributed, by means of the dispersing and descending
functions of the lung as well as the function of the heart to control blood, to the
whole body to warm and nourish the internal organs and tissues to maintain their
normal physiological functions. Since fresh air in the natural world is a necessary
condition for the production of the pectoral qi and is inhaled into the body by the
lung, the respiratory function of the lung directly influences the production of the
pectoral qi and qi in the whole body.
The second aspect is the regulation of qi activity. Qi is flowing constantly in the body.
The movement of qi is characterized by ascending, descending, going-out and entering.
The lung functions to disperse and descend directly influencing the activity of qi. The
respiratory function of the lung, reflecting the ascending, descending, going out and
entering activities of qi, also exerts great effect on the movement of qi in the whole
body. If the lung is normal in dispersion and descent as well as respiration, the visceral
qi and the meridian qi in the whole body will be normal in ascending, descending, going-
out and entering. It is clear that the lung regulates the activities of qi in the whole body.
The third aspect is to assist the heart to promote blood circulation. The heart controls
blood vessels and the heart beat is the basic motive power to propel blood to circulate
39
in the vessels. Besides, the lung is closely related to the vessels in the whole body.
Because through the vessels blood from the whole body converges in the lung and then
is distributed to all parts of the body. That is why it is said in Huangdi Neijing that ―the
lung is connected with all the vessels‖. It is just the convergence of blood from the
whole body in the lung that makes it possible for the lung to assist the heart to promote
blood circulation and to accomplish the activity of respiration.
As it is mentioned above, the function of the lung to govern qi in the whole body is
closely related to the function of the lung to control respiration. The latter is the base of
the former and the former is the aim of the later. If the lung is abnormal in governing
respiration, it will affect the production of the pectoral qi, the regulation of qi activity and
the circulation of blood, leading to insufficiency of the pectoral qi, disturbance of qi
activity and disorder of qi and blood. The function of the lung to govern respiration will
be affected if the production of the pectoral qi is insufficient or if the lung is abnormal in
dispersion and descent or if blood circulation is in disorder.
b. The regulation of water passage
Regulation here means dredging and readjusting. Water passage refers to the route for
transmitting and discharging water. The lung governing the regulation of water passage
refers to the function of the lung in propelling, adjusting and discharging water.
After taken into the body, water is absorbed by means of transportation and
transformation of the spleen, and then transmitted upwards to the lung. On the one
hand, lung-qi, by means of dispersing to the upper and external, transmits water to the
surface of the body and transforms it into sweat to be discharged. At the same time,
part of the water is excreted through respiration. On the other hand, lung-qi, by means
of descending to the lower and the internal, transmits water to the viscera and then to
the kidney where it is transformed into urine to be excreted out of the body. Besides, the
descending function of the lung assists the large intestine in transmission, through
which part of the water is discharged in defecation. Since the location of the lung is
supreme, like a canopy, and because it also participates in the metabolism of water, the
lung is called ―the upper source of water‖ in TCM. If the lung fails to regulate water
passage due to its disorder in dispersion and descent, it will affect the distribution and
discharge of water, leading to production of phlegm, rheum, edema and disorder of
urination.
III. The liver
1. The liver is located below the diaphragm and in the right rib-side. The liver ―pertains
to yin in entity and yang in function‖. This is the physiological characteristics of the liver.
As one of the five zang-organs, the liver pertains to yin because it stores yin-blood.
However in function the liver pertains to yang because yang-qi in the liver is very active
40
and resolute, tending to disperse. That is why the liver is described as ―a general
organ:.
2. The physiological functions of the liver
The liver possesses two physiological functions: to govern shu-xie (dredging and
regulating) and to store blood.
a. To dredge and regulate
Shu-xie in Chinese means to dredge and smooth the route of something. The liver
governing shu-xie actually means that the liver dredges the routes and regulates the
movement of qi so as to ensure smooth flow of qi in the body. The movement of qi is
described as qi-ji (qi activity) in TCM. So to regulate the movement of qi means to
regulate the activity of qi. The physiological activities of all the internal organs and
tissues depend on the normal movement of qi. Since the liver can regulate the activity of
qi, it plays an important role in regulating the physiological functions of all the internal
organs and tissues. The function of the liver to regulate qi activity is demonstrated in the
following aspects.
(1) To promote circulation of blood and metabolism of body fluid

(2) To assist the spleen and the stomach to digest food
(3) To regulate mental activity
(4) To regulate menstruation
b. To store blood
The liver storing blood refers to the function of the liver to store blood and regulate the
volume of blood.
The physiological significance of the liver to store blood lies in the fact that liver-blood
nourishes the liver itself. With the nourishment of blood, the liver will have sufficient yin-
fluid to prevent liver-yang from becoming hyperactive. Besides, in the course of
regulating blood volume, liver-blood can nourish the tissues and organs in the whole
body to sustain their physiological activities.
The liver storing blood is a course in which blood enters the liver and comes out of the
liver. Under physiological condition, the volume of blood in different parts of the body
varies due to the difference of their physiological activities. Generally speaking, the
organs in the body comparatively need less blood when the body is in a quiet state, the
rest of blood flows into the liver. When the blood takes strenuous activities or when
people become excited, the organs in the body comparatively need more blood. In this
case, the liver transports blood stored to other parts of the body to meet the need of
their physiological activities. If physiological activities are different, the volume of blood
41
needed is also different. In fact the blood needed by different organs and tissues
constantly varies with the change of physiological activities. Such a constant variation is
also closely related to the function of the liver to store blood. That is to say that the liver,
based on its function to store blood, adjusts the volume of blood to meet the need of
different physiological activities.
If the function of the liver to store blood is in disorder, it may lead to two kinds of
pathological changes. One is insufficiency of liver-blood. In this case the body cannot
get enough nourishment, leading to dizziness, vertigo, weakness of limbs, scanty and
light-colored menses or amenorrhea. The other is failure of the liver to store blood which
may lead to abnormal flow of blood, causing various symptoms such as haematemesis,
epistaxis, heamatochezia and profuse menorrhea, or even constant haematemesis or
sudden profuse uterine bleeding in severe cases.
IV. The spleen
1. The spleen, located in the abdomen, governs digestion and absorption. As the
source of qi, blood and body fluid, the spleen plays a vital role in maintaining life
activities. Such a function of the spleen only comes into play after birth. That is why it is
said that ―the spleen is the acquired base of life‖ and ― the source of qi, blood and body
fluid‖.
2. The physiological functions of the spleen
a. To govern the transportation and transformation
The function of the spleen to govern transportation and transformation means that the
spleen can digest food, absorb nutrients of food and water, and then transport them to
the heart and the lung.
When taken into the stomach, food is digested and absorbed by the stomach and the
small intestine. But it must depend on the transporting and transforming functions of the
spleen to transform into nutrients which, relying on the functions of the spleen to
transmit and dispersing essence, are distributed to the four limbs and the other parts of
the body. The rest of the water absorbed from the food nutrients is transported to the
lung and the kidney and, by means of qi transformation taking place in the lung and the
kidney, transformed into sweat and urine to be excreted out of the body. So the
transporting and transforming functions of the spleen are usually divided into two parts:
transporting and transforming food nutrients, and transporting and transforming water.
Since the transporting and transforming of food nutrients and water take place at the
same time in the process of digesting, absorbing and transmitting food, they are closely
related to each other and pathologically affect each other.
42
b. To command blood
To command means to control. To command blood means that the spleen controls
blood circulation inside the vessels and prevent it from flowing out of the vessels.
The spleen commands blood with its fixating function. If spleen-qi is sufficient, it can
control blood and directs blood to circulate inside the vessels. Such a function of the
spleen is also related to spleen-yang. Thus deficiency of spleen-qi and spleen-yang will
impair the function of the spleen to command blood, leading to heatochezia, hematuria,
sudden profuse uterine bleeding and subcutaneous purpura.
V. THE KIDNEY
1. The kidney is located in the waist. That is why it is said in Huangdi Neijing that ―the
waist is the house of the kidney‖. The kidney stores essence and the essence
transforms qi and produces blood. Besides, the kidney is the source of genuine yin and
genuine yang. So the kidney is closely related with the essence, qi, blood, yin and yang.
Since the kidney-essence comes from parents and is the primary substance for
constituting human body and conceiving new life, TCM regards the kidney as ―the
prenatal base of life‖.
2. The physiological functions of the kidney.
The physiological functions of the kidney are composed of six parts: to govern growth
and development, to govern reproduction, to govern water, to govern reception of qi, to
produce marrow to enrich the brain and transform blood and to nourish and warm the
internal organs.
a. To govern growth and development
The kidney stores essence, qi, yin and yang. The growth and development of the body
mainly depend on the kidney-essence, kidney-yin and kidney-yang. After birth, the
kidney-essence gradually becomes abundant with the development of the body. During
the childhood, the abundance of the kidney-essence is marked by dental transition,
growth of hair and body. During youth period, the kidney-essence is further enriched,
marked by full development of all organs and maturity of reproductive function. During
the mid-age and prime period of life, the kidney-essence has developed to its peak,
characterized by sturdy build, rich vitality and strong tendons and bones. After the mid-
age and during the old-age, the kidney-essence gradually declines, and so are the
functions of the five zang-organs and six fu-organs, leading to a series of signs of
senility, such as loss of hair and teeth, hunch-back, poor hearing and gradual loss of
reproductive function. At different stages of life process, the body and its physiological
functions vary with the changes of the essence in the kidney. That is to say the
43
essence, qi, yin and yang in the kidney decide the growth and development of the body.
If these substances in the kidney are deficient, the growth and development of the body
will be affected, leading to a series of phathological manifestations, such as
hypoevolutism, feeblemindedness, atrophy and flaccidity of tendons and bones as well
as senilism.
b. To govern reproduction
The reproductive function includes the development of sex organs, maturity and
maintenance of sex as well as fertility which are all closely related with the kidney-
essence, kidney-yin and kidney-yang. When the body develops to the period of youth,
the essence in the kidney enriches to a certain degree and produces a kind of
reproductive substance known as tiankui which can promote the development of sex
organs and maintain normal sex function. Consequently man has sperm and
experiences seminal emission, and woman has menarche. These physiological
changes indicate genitality. Man and woman maintain such a sex function and geitality
after their middle age. At the period of old age, the kidney-essence gradually declines.
Subsequently, tiankui becomes exhausted and, accordingly, genitality declines and
disappears in the end. This shows that the essence, qi, yin and yang in the kidney play
a key role inthe genitality and reproduction. If these vital substances are deficient, the
genitality and reproduction will inevitalby be affected, leading to maldevelopment of sex
organs, weakness of sex function and sterility.
c. To govern water
To govern water means that the kidney controls the metabolism of water.
The metabolism of water is related to many organs like the lung that regulates water
passage, the spleen that transports and transforms water, the liver that promotes the
metabolism of water and the triple energizer that serves as the passage of water.
However, the function of the kidney to govern water is key to the metabolism of water.
When taken into the stomach, the water is transmitted to the kidney with the collective
action of the spleen, the lung, the liver and the triple energizer. The kidney regulates the
whole process of transporting and excreting water, playing a very important role in
maintaining a holistic balance of water metabolism. It is said in Huang-di Neigjing that
―the kidney is the door of the stomach. If the door is not properly closed, water will be
accumulated inside the body.‖
d. To govern reception of qi
Reception means acceptance and storage. To govern reception of qi means that the
kidney can receive fresh air inhaled by the lung to assist the lung to govern respiration.
44
The respiratory activity is controlled by the lung. But the fresh air inhaled by the lung
from the natural world has to be descended into the kidney to ensure free and smooth
respiration and keep the respiration into a certain depth so as to meet the need of
various viscera and tissues for fresh air. There is a close relationship between the
function of the lung to govern respiration and the function of the kidney to receive qi.
The former is prerequisite to the latter and the latter is the basic condition of the former.
Normal respiration is accomplished by coordinative action of both the lung and the
kidney.
e. To produce marrow to enrich the brain and transform blood
The kidney stores essence and the essence stored in the kidney can produce marrow.
The marrow includes cerebral marrow, spinal cord and bone marrow. When transported
into the bones, the marrow can nourish the bones. That is why TCM believes that ― the
kidney governs the bones‖. The spinal cord is connected with the brain, nourishes the
brain and maintains the physiological functions of the brain together with the cerebral
marrow. That is why the brain is called ―the sea of marrow‖ in TCM. If the kidney-
essence is insufficient, the production of cerebral marrow will be reduced, leading to
various pathological changes, such as headache, dizziness, amnesia and retard
response.
The production of blood, apart from the transformation of food nutrients by the spleen
and stomach, is related to the kidney-essence. Physiologically the kidney-essence and
blood promote each other and transform into each other. So sufficient kidney-essence
ensures abundant production of blood while deficient kidney-essence leads to
insufficient production due to deficiency of kidney-essence must be treated by the
therapy for nourishing the kidney and enriching the essence.
f. To nourish and warm the viscera
Kidney-yin and kidney-yang restrain each other and depend on each other, playing an
important role in maintaining the normal functions of the kidney. Kidney-yin, also known
as primordial yin or genuine yin, can nourish yin in all the viscera, serving as the source
of yin-fluid in the body. Kidney-yang, also known as primordial yang or genuine yang,
can warm yang in all the viscera, serving as the source of yang-qi in the whole body.
Since kidney-yin and kidney-yang are the sources of yin and yang in the other viscera,
the deficiency of kidney-yin and kidney-yang may lead to deficiency of yin and yang in
the other viscera. Clinically, deficiency of kidney-yin mainly leads to deficiency of liver-
yin, heart-yin and lung-yin; deficiency of kidney-yang mainly brings on deficiency of
spleen-yang and heart-yang. On the other hand, yin-essence and yang-qi in the kidney
depend on the essence, yin and yang in the other organ to nourish and foster. Thus
insufficiency of yin-essence or yang-qi in the other viscera will eventually involve the
45
kidney or consume yin-essence or yang-qi in the kidney, or prevent the kidney from
storing essence, consequently leading to deficiency of essence, yin and yang in the
kidney. This is what ―impairment of the five zang-organs inevitably exhausting the
kidney‖ means.
PRACTICE

1 locate
2 regulate
3 urinate
4 nourish
5 store
6 fail
7 circulate
8 respire
9 move
10 digest
1. The five zang-organs __________ the heart, the lung, the liver, the spleen and the
kidney.
A. consist B. include C. compose D. contain of
2. The five constituents include the vessels, the skin, the tendons, the muscles and the
bones __________ by the five zang-organs respectively.
A. that are dominated B. dominating
C. which is dominated D. dominate
3. The heart is located in the __________ between the two lobes of the lung.
A. chest B. thorax C. thoracic cavity D. All are correct.
4. The idea __________ the heart controls the mind means that the heart governs the
mental activities.
A. that B. which C. where D. what
5. The lung is delicate, __________ cold and heat, and is easy to be attached by
pathogenic factors. That is why it is called ―a delicate organ‖.
A. intolerable of B. tolerable of C. intolerable to D. tolerable to
46
6. If the lung fails to regulate __________ due to its disorder in dispersion and descent,
it will affect the distribution and discharge of water, leading to production of phlegm,
rheum, edema and disorder of urination.
A. water passage B. air passage C. tubular passage D. lobular passage
7. The liver __________ below the diaphragm and in the right rib-side. The liver
―pertains to yin in entity and yang in function‖.
A. is lying B. is located C. situated D. houses
8. The physiological significance of the liver to store blood lies in the fact that liver-blood
nourishes the liver itself. With the nourishment of blood, the liver will have sufficient yin-
fluid to prevent liver-yang from __________.
A. to become hyperactive B. to become hypoactive
C. becoming hyperactive D. becoming hypoactive
9. If the function of the liver to store blood is in disorder, it may __________ two kinds of
pathological changes. One is insufficiency of liver-blood and __________ is failure of
the liver to store blood which may lead to abnormal flow of blood.
A. lead to / another B. result from / the other
C. result in / another D. lead to / the other
10. The transporting and transforming functions of the spleen __________ two parts:
transporting and transforming food nutrients, and transporting and transforming water.
A. are usually divided into B. are usually dividing into
C. divide into D. are usually divided of
1. The function of the heart govern blood means that the heart propels blood to
A B
circulate in the vessels and that the heart is related to the production of blood.
C D
2. After digestion and absorption of food by the spleen and stomach, the refining
A B C
nutrients are transported up to the heart and the lung.
D
3. Combined with the fresh air inhaled into the lung, warmed and steamed by heart-
A B C
yang, these refined nutrients transformed into red blood.
D
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4. After taken into the body, water is absorbed by means of transportation and transform
A B C
of the spleen, and then transmitted upwards to the lung.
D
5. Since the liver can regulate the activity of qi, they play an important role in regulating
A B C
the physiological functions of all the internal organs and tissues.
D
6. Before taken into the stomach, food is digested and absorbed by the stomach and
A B C D
the small intestine.
7. The physiological functions of the kidney composed of six parts: to govern growth
A B
and development, to govern reproduction, to govern water, to govern reception of qi, to
C
produce marrow to enrich the brain and transform blood and to nourish and warm the
D
internal organs.
8. The kidney regulates the whole process of transporting and excretion water, playing a
A B C D
very important role in maintaining a holistic balance of water metabolism.
9. The fresh air inhaled by the lung from the natural world has to be descended into the
A
kidney to ensure free and smooth respiration and keep the respiration into a certain
B
depth so to meet the need of various viscera and tissues for fresh air.
C D
10. The kidney stores essence and the essence transforms qi and produces blood.
A
Beside, the kidney is the source of genuine yin and genuine yang.
B C D
sentences.
1. The function of the heart to control the mind is also ___________ as ―the heart
storing spirit‖. (know)
48
2. The lung is the main organ involved in ___________ movement and the place where
air is in and out of the body exchanges. (respiration)
3. The liver possesses two ___________ functions: to govern shu-xie (dredging and
regulating) and to store blood. (physiology)
4. The spleen, located in the abdomen, governs digestion and ___________. (absorb)
5. The kidney stores essence and the essence stored in the kidney can produce marrow
which includes cerebral marrow, ___________ cord and bone marrow. (spine)
6. The ___________ and development of the body mainly depend on the kidney-
essence, kidney-yin and kidney-yang. (grow)
7. After the mid-age and during the old-age, the kidney-essence gradually declines, and
so are the functions of the five zang-organs and six fu-organs, leading to a series of
signs of senility, such as ___________ of hair and teeth, hunch-back, poor hearing and
gradual loss of reproductive function. (lose)
8. The ___________ of water is related to many organs like the lung that regulates
water passage, the spleen that transports and transforms water, the liver that promotes
the metabolism of water and the triple energizer that serves as the passage of water.
(metabolize)
9. If the kidney-essence is insufficient, the ___________ of cerebral marrow will be

reduced, leading to various pathological changes, such as headache, dizziness,
amnesia and retard response. (production)
10. Kidney-yin and kidney-yang restrain each other and depend on each other, playing
an important role in ___________ the normal functions of the kidney. (maintain)
Heart
circulation tongue intestine vessels empty
lead sufficient functions heart interrelated
From the TCM perspective, the main physiological (1) __________ and indicators of
the heart includes (1) the domination of blood and vessels, and facial complexion, (2)
control of the mind; and (3) opening into the (2) __________ .
The heart has an "exterior" (biao) and "interior" (li) relationship with the small (3)
__________ .
49
Dominating Blood and Vessels, and Facial Complexion
The (4) __________ dominates the blood and vessels indicating its function of
promoting blood circulation. In the Suwen, it says, "... The heart is in charge of the blood
vessels ...." The vessels are the pathways of blood (5) __________ while the heart is
the motive power of blood circulation. Only if there is ample heart qi can the blood
circulate incessantly in the vessels to nourish the whole body. The heart, blood, and
vessels are (6) __________ . Because of the rich distribution of blood (7) __________
in the facial region, the color and luster of the complexion usually reflects the sufficiency
or insufficiency of the blood supply and heart qi. If the heart blood supply is (8)
__________ , then the pulse beats normally and forcefully and the facial complexion is
rosy with luster. If the heart qi is insufficient, the vessels will be (9) __________ , the
pulse feeble and weak or irregular and the facial complexion pale. Insufficient heart qi
may (10) __________ to blood stagnation manifested by a blue complexion. So, "The
heart is the root of live, ... its luster is manifested in the face, it fills up the blood vessels
..."
VI. Translate the following passage into Vietnamese.
Heart - Controlling the Mind
Mind here indicates spirit, consciousness, and thinking. Traditional Chinese medicine
considers that mind refers to the five zang organs, especially the heart. So in the
Lingshu it says, "The organ that is responsible for the performance of activities is the
heart." This means the process of thinking is accomplished by the heart. Blood is the
main foundation for mental activities, thus the function of heart controlling the mind is
closely related to the function of heart dominating the blood and the vessels. If there is
plenty of heart blood, the mind is clear, thinking is nimble, and one is full of vim and
vigor. If heart blood is insufficient, it will lead to the pathological changes of heart-mind
manifested by palpitation, insomnia, dream disturbed sleep, poor memory, restlessness,
etc. If heat in the blood disturbs the heart-mind, there will be delirium, coma, etc.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
50
______________________________________________________________________
______________________________________________________________________
The five organs network
One of the central features of traditional Chinese medicine is the analysis of diseases
and their treatment in terms of the five zang (often translated as viscera, solid organs, or
internal organs). That there are five internal organs that represent the focus of this
medical system is a reflection of traditional reliance on the five elements concept. The
concept of yin and yang, the other basis for Chinese medicine, is reflected in the
depiction of pairs of internal organs: for each zang, there is a fu (often described as
hollow organs) and the complete system is described as zangfu .
The term "organ networks" is utilized here to indicate that Chinese physicians were not
interested in the organs as physical objects, but as extended networks functioning
throughout the body. In modern medicine, it is common to look at the internal organs as
individual physical units, subject to inspection and surgical removal (in part or in whole).
By contrast, the Chinese system was developed by considering the person as a whole
and by relying on what is visible or palpable at the surface. The Chinese organ networks
were described in nearly complete absence of surgery .
In classical Chinese medicine, detailed knowledge of the dynamics and interrelationship

of the five organ networks is considered the foundation for successful practice. This
system of knowledge describes the body as a dynamic system of intertwined functional
circuits that reflect and resonate with the macrocosm of the universe.
Unfortunately, the traditional view of the organs is made difficult to understand by the
fact that organs known to modern medicine have been directly linked, by naming, to
those of traditional medicine, as follows:
Element Zang Western name Fu Western name
Wood gan liver dan gallbladder
Metal fei lung dachang large intestine
Earth pi spleen wei stomach
Fire xin heart xiaochang small intestine
Water shen kidney pangguang bladder
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Questions
1. What is one of the central features of traditional Chinese medicine?
______________________________________________________________________
______________________________________________________________________
2. How is the concept of yin and yang reflected?
______________________________________________________________________
______________________________________________________________________
3. Why is the term "organ networks" is used here?
______________________________________________________________________
______________________________________________________________________
4. What difference is mentioned about modern medicine and the Chinese system?
______________________________________________________________________
______________________________________________________________________
5. In classical Chinese medicine, what does the system of knowledge describe?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
52
UNIT
THE FU-ORGANS
4
A. THE SIX FU-ORGANS
The six fu-organs refer to the gallbladder, the stomach, the small intestine, the large
intestine, the bladder and the triple energizer. The common physiological function of the
six fu-organs is “to transmit and transform food”, i.e. receiving and digesting food,
absorbing the nutrients and excreting the waste. Since the six fu-organs should be clear
in order to transmit and transform food, it is said that ―the six fu-organs function to
descend‖ and ― the six fu-organs function well if they are unobstructed‖.
I. THE GALLBLADDER
The gallbladder is connected with the liver and contains bile. The bile comes from the
liver and is the accumulation of the surplus part of liver-qi. The bile is yellow in colour
and bitter in taste, playing an important role in assisting the absorption of food. That is
why the bile is called “the essential juice” or “the lucid juice” and the gallbladder is
called “the fu-organ of essential juice‖ or “the fu-organ of lucid juice” in traditional
medicine.
The physiological function of the gallbladder is to store and excrete the bile. The
gallbladder itself is empty. After produced by the liver, the bile is stored in the
gallbladder and directed by dredging and dispersing functions of the liver, excreted into
the small intestine to participate in the process of digestion and absorption of food and
promote the small intestine to separate the lucid from the turbid.
Whether the excretion of the bile is normal or not is concerned with the dredging and
dispersing functions of the liver on the one hand and the obstructed condition of the
gallbladder on the other. Failure of the liver to dredge and disperse or obstruction of the
gallbladder itself will affect the excretion of the bile and disturb digestion and absorption,
frequently leading to anorexia, abdominal distension, vomiting, hypochondriac pain or
even jaundice if the bile is extravasated in the muscles and skin.
53
II. THE STOMACH
The stomach is connected with the esophagus in the upper and the small intestine in
the lower, usually divided into three parts, namely shangwan (the upper part of the
stomach and cardia), zhongwan (the middle part of the stomach) and xiawan (the lower
part of the stomach and pylorus).
The physiological function of the stomach is to receive and digest food. The chyme
transformed in the stomach is then transmitted to the small intestine. Since the stomach
is big and can contain large amount of food, it is called ―the sea of food and water‖.
The stomach depends on the propelling of stomach-qi to perform its function. Stomach-
qi is the basic motive power for transmitting food and water in the stomach downwards.
The canal connecting the stomach and the small intestine must be kept unobstructed so
that the chyme can smoothly be transmitted from the stomach to the small intestine.
That is why the physiological function of the stomach is often described as ― the
stomach functions to descend‖ and ―the unobstructed condition is prerequisite to the
normal function of the stomach‖ in traditional medicine, usually abbreviated as ―the
stomach governing descent‖. Dysfunction of the stomach will lead to distending
stomach-ache and poor appetite due to disharmony of stomach-qi, or belching,
vomiting, nausea and hiccup due to failure of stomach-qi to descend or upward flow of
stomach-qi. Since the food received and digested by the stomach is the main substance
for producing qi and blood, the stomach is called ―the sea of food‖.
III. THE SMALL INTESTINE
The small intestine is located in the middle of the abdomen, connected with the stomach
at the pylorus in the upper and the large intestine at ileocecal junction in the lower. The
physiological function of the small intestine is to receive the chyle and separate the lucid
from the turbid. The lucid refers to food nutrients and the turbid refers to the waste of
food. After further digestion and absorption of the nutrients and part of the water, the
small intestine transmits the waste to the large intestine. This process is called ―to
separate the lucid from the turbid‖ in traditional medicine.
Traditional medicine emphasizes the functions of the five zang-organs, so the digesting
function of the small intestine is attributed to the transporting and transforming function
of the spleen. That is why clinical diseases due to disorder of the small intestine in
digestion and absorption, such as anorexia, abdominal distension and loose stool, are
differentiated as ―dysfunction of the spleen‖ and treated from the aspect of the spleen.
IV. THE LARGE INTESTINE
The large intestine is connected with the small intestine in the upper and the anus in the
lower. The physiological function of the large intestine is mainly to receive the waste of
food transmitted down from the small intestine. After absorbing part of water in it, the
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large intestine transmits the waste downward and transforms it into stool to be excreted
from the anus.
The function of the large intestine is to transmit the waste of food is described as
―transmission and excretion‖, the activities of which are accomplished by the propelling
function of the large intestinal qi. If the large intestine is abnormal in function, it will lead
to constipation due to improper transmission and diarrhea due to insufficient absorption
of water.
V. THE BLADDER
The bladder, located in the lower abdomen, is responsible for storing and discharging
urine. The water and turbid qi produced in the process of metabolism are changed into
urine through qi-transforming function of the kidney and transmitted to the bladder.
When certain amount of urine is accumulated in the bladder, it is excreted naturally out
of the body through the action of qi-transformation. The storage and excretion of urine
by the bladder result from the fixating and qi-transforming functions of qi. Since bladder-
qi is controlled by the kidney-qi, the fixating and qi-transforming functions of the kidney-
qi is key to the storage of urine in the bladder and excretion of urine out of the bladder.
Generally speaking, failure of kidney-qi to fixate and transform qi due to deficiency
affects the function of the bladder to excrete urine. Deficiency of bladder-qi usually
leads to symptoms of polyuria, enuresis and incontinence of urine. Obstructed
transformation of qi often brings on symptoms of unsmooth urination, dripping urination
and anuria.
VI. SANJIAO – THE TRIPLE ENERGIZER
The triple energizer is a special fu-organ, serving to divide the internal organs in the
chest and abdomen and generalize certain functional systems of the body.
The triple energizer is composed of three parts, i.e. the upper energizer, the middle
energizer and lower energizer. The diaphragm and the navel are regarded as the lines
to divide the triple energizer. The part above the diaphragm is the upper energizer, the
below the diaphragm and above the navel is the middle energizer, and the part below
the navel is the lower energizer. The upper energizer includes the thorax, the heart and
the lung; the middle energizer includes the upper abdomen, the spleen, the stomach,
the liver, the gallbladder and the small intestine; the lower energizer includes the lower
abdomen, the kidney, the bladder and the large intestine.
The triple energizer is an independent functional system which is based on the
morphological structure of the internal organs and tissues. In fact, it is a generalization
of the physiological functions of the internal organs. The physiological functions of the
triple energizer include the following two aspects:
1. A generalization of yuan-qi (primordial qi) and water passage
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The triple energizer serves as a transmitting system, through which sbstances like the
primordial qi and water are transported and transmitted. If the triple energizer is
obstructed, the functions of the lung, the spleen and the kidney will certainly be affected,
leading to oliguria and edema.
2. A generalization of the physiological functions of certain internal organs.
The generalization of the physiological functions of certain viscera with the triple
energizer is mainly concerned with the digestion and absorption of food, distribution of
food nutrients and metabolism of water.
When exogenous pathogenic factors invade the upper energizer, it not only affects the
dispersion and distribution of essence, but also leads to the symptoms of dysphoria,
palpitation, cough and chest oppression due to dysfunction of the heart and lung.
If pathogenic factors are retained in the middle energizer, the digesting and absorbing
functions will be affected, leading to distending fullness of the upper abdomen, vomiting,
diarrhea and jaundice.
If pathogenic factors invade the lower energizer, the excretion of urine will be affected,
leading to oliguria, frequent urination, urgent urination and pain in urination.
B. THE EXTRAORDINARY FU-ORGANS
The extraordinary fu-organs refer to another group of tissues and organs. These are
characterized by hollowness, similar to the six fu-organs in morphology, and storage of
essence, similar to the five zang-organs in function. That is why this group of tissues
and organs are called the extraordinary fu-organs, including the brain, the marrow, the
bones, the vessels, the gallbladder and the uterus. Among the extraordinary fu-organs,
the gallbladder is a special one. It is hollow inside and excretes bile to promote
digestion, similar to the functions of the six fu-organs, but it also stores bile which is part
of the essence, similar to the functions of the five zang-organs. That is why the
gallbladder belongs both to the six fu-organs and the extraordinary fu-organs.
The following paragraphs are only devoted to the functions of the brain and the uterus.
I. The brain
The brain is located in the skull and is composed of marrow. The physiological functions
of the brain include the following aspects:
1. The center of life activities
The brain plays a very important role in life activities. It governs the five zang-organs
and six fu-organs and regulates life activities. Impairment of the brain will threaten life.
2. Governing the mental activities
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The brain is also an organ responsible for cognition and thinking. All the mental
activities result from the reflection of things in the objective world. When the brain is
normal in function, people will be full of vigor, clear in thinking, fluent in speaking and
strong in memory. If the brain is abnormal in function, it will lead to dispiritedness, retard
thinking, dizziness, poor memory or mental disorder.
3. Governing sensation and motion
There are various sensory organs in the body, such as the eyes, ears, nose, tongue and
skin that respectively receive sound, light and flavor as well as the stimulation of pain,
cold and heat. The brain receives such stimulation through the meridians. The brain
also governs the limbs. The brain transmits the order to move through the meridians to
the limbs. The brain also constantly regulates the movement of the limbs. That is why
the movement of the limbs is rhythmical and accurate. If the brain is abnormal in
governing and regulating the limbs, it will cause bradyesthesia and dyskinesia.
II. The uterus
The uterus is located in the lower abdomen. The physiological function of the uterus to
produce menses and conceive fetus is a complicated process and depends on the
nourishment and coordination of other viscera. Often the following three factors are
involved in the process.
1. Essence stored in the kidney
When essence, yin and yang stored in the kidney develop to a certain level, tiankui
(reproductive substance) occurs. Tiankui can promote the development and maturation
of the genitals, including the uterus. When the uterus becomes matured, it is ready to
produce menses and conceive fetus. When a woman becomes old, essence, yin and
yang stored in the kidney are gradually reduced, and so is tiankui. Eventually
menstruation stops and the uterus can no longer conceive fetus.
2. The function of liver-qi and liver-blood
The liver plays a very important role in the physiological functions of the uterus. On the
one hand, the liver governs dredging and dispersing activities and regulates the
movement of qi. With the assistance of the liver, the uterus functions normally. On the
other hand, the liver stores blood and regulates the volume of blood. Such a function of
the liver is closely related to the quantity of menses and nourishment of the fetus.
3. The functions of the thoroughfare and conception vessels
The thoroughfare and conception vessels start from the uterus. The thoroughfare vessel
regulates qi and blood in the twelve regular meridians. The conception vessel governs
the uterus and pregnancy. If these two vessels function well, blood will be transported
smoothly into the uterus to ensure regular menses and conception of fetus. The
functions of these two vessels are assisted and regulated by the kidney and the liver. In
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fact, the kidney, the liver, the thoroughfare and conception vessels physiological
coordinate with each other to influence the uterus.
Besides, the heart, the lung and the spleen also influence the functions of the uterus.
Because the heart governs blood and propels the circulation of blood, the lung governs
qi and directs the flow of blood, and the spleen commands blood, governs
transportation and transformation and serves as the source of qi and blood.
C. THE RELATIONSHIPS AMONG THE ZANG-ORGANS AND THE FU-ORGANS
The human body is an organic whole, composed of the viscera, the meridians and many
other tissues and organs. The relationship between the zang-organs and the fu-organs
are a component part in the theory of zangxiang. The zang-organs and the fu-organs
are connected with each other through the meridians in structure, coordinate with each
other and differ from each other in physiology as well as affect each other and transmit
to each other in pathology.
The relationship between the five zang-organs and the six fu-organs, though
complicated, can be summarized as ―mutual internal and external relationship‖. The
zang-organs pertain to yin while the fu-organs to yang. Yin controls the internal and
yang manages the external. Such a coordination between yin and yang as well as the
internal and external makes up a special mutual internal and external relationship
between the zang-organs and the fu-organs.
PRACTICE

1 Absorb
2 Accumulate
3 Assist
4 Depend
5 Excrete
6 Impair
7 Metabolize
8 Obstruct
9 Oppress
10 Transmit
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1. The bile is yellow in colour and ___________ in taste, playing an important role in
assisting the absorption of food.
A. sour B. sweet C. bitter D. salty
2. The physiological function of the gallbladder is to store and ___________ the bile.
The gallbladder itself is empty.
A. secrete B. excrete C. release D. discharge
3. The physiological function of the ___________ is to receive and digest food.
A. stomach B. gallbladder C. small intestine D. large intestine
4. The physiological function of the small intestine is to receive the ___________ and
separate the lucid from the turbid.
A. food B. mixture C. fluid D. chyle
5. The large intestine is connected with the small intestine in the upper and the
___________ anus in the lower.
A. duodenum B. jejunum C. ileum D. anus
6. The heart, the lung and the spleen also ___________ the functions of the uterus.
A. influence B. affect C. impact D. All are correct.
7. The extraordinary fu-organs refer to another group of ___________ and organs.

A. tissues B. cells C. systems D. molecules
8. ___________ the extraordinary fu-organs, the gallbladder is a special one.
A. Between B. Besides C. Among D. Beside
9. The human body is an organic whole, composed of the viscera, the ___________
and many other tissues and organs.
A. roots B. meridians C. fu-organs D. zang-organs
10. ___________ controls the internal and ___________ manages the external.
A. Yang / yin B. Fu / zang C. Yin / yang D. Zang / yang
1. The six fu-organs refers as the gallbladder, the stomach, the small intestine, the large
A B
intestine, the bladder and the triple energizer.
C D
2. The commonly physiological function of the six fu-organs is ―to transmit and
A B C
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transform food‖, i.e. receiving and digesting food, absorbing the nutrients and excreting
D
the waste.
3. The gallbladder is connected with the liver and contained bile. The bile comes from
A B
the liver and is the accumulation of the surplus part of liver-qi.
C D
4. The stomach depends on the propelling of stomach-qi to perform their function.
A B C
Stomach-qi is the basic motive power for transmitting food and water in the stomach
D
downwards.
5. The small intestine located in the middle of the abdomen, connected with the
A B
stomach at the pylorus in the upper and the large intestine at ileocecal junction in the
C D
lower.
6. The physiological function of the large intestine is main to receive the waste of food
A B
transmitted down from the small intestine.
C D
7. The bladder, located in the lower abdomen, is responsible for storing and discharge
A B C D
urine.
8. The triple energizer is a special fu-organ, serving to divide the internal organs in the
A
chest and abdomen and generalizes certain functional systems of the body.
B C D
9. The brain is located in the skull and is composed of marrow. It plays a very important
A B C
role in life activity.
D
10. The uterus is located in the lower abdomen. The physiological function of the uterus
A
to produce menses and conceive fetus is a complicated process and depend on the
B C
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nourishment and coordination of other viscera.
D
sentences.
1. After produced by the liver, the bile is stored in the gallbladder and directed by
dredging and dispersing functions of the liver, excreted into the small intestine to
participate in the process of digestion and ___________ of food and promote the small
intestine to separate the lucid from the turbid. (absorb)
2. The stomach is connected with the esophagus in the upper and the small intestine in
the lower, usually ___________ into three parts, namely shangwan (the upper part of
the stomach and cardia), zhongwan (the middle part of the stomach) and xiawan (the
lower part of the stomach and pylorus). (division)
3. Dysfunction of the stomach will lead to distending stomach-ache and poor appetite
due to disharmony of stomach-qi, or belching, vomiting, nausea and hiccup due to
___________ of stomach-qi to descend or upward flow of stomach-qi. (fail)
4. Traditional medicine ___________ the functions of the five zang-organs, so the
digesting function of the small intestine is attributed to the transporting and transforming
function of the spleen. (emphasis)
5. The function of the large intestine ___________ the waste of food is described as
―transmission and excretion‖. (transmission)
6. The brain is also an organ ___________ for cognition and thinking. All the mental
activities result from the reflection of things in the objective world. (responsibility)
7. There are ___________ sensory organs in the body, such as the eyes, ears, nose,
tongue and skin that respectively receive sound, light and flavor as well as the
stimulation of pain, cold and heat. (variety)
8. The relationship between the five zang-organs and the six fu-organs, though
complicated, can be summarized as ―___________internal and external relationship‖.
(mutuality)
9. The liver plays a very important role in the ___________ functions of the uterus.
(physiology)
10. The water and turbid qi produced in the process of ___________ are changed into
urine through qi-transforming function of the kidney and transmitted to the bladder.
(metabolize)
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The Zang-Fu Theory
small intestine filled excrete consist functions
extraordinary are pathology store explains
The zang-fu theory (1) __________ the physiological function, pathological changes,
and mutual relationships of every zang and fu organ. In traditional Chinese medicine,
the zang and fu organs (2) __________ not simply anatomical substances, but more
importantly represent the generalization of the physiology and (3) __________ of
certain systems of the human body.
Zang and fu (4) __________ of the five zang and six fu organs. The five zang organs
are the heart (including the pericardium), lung, spleen, liver, and kidney. The six fu
organs are the gall bladder, stomach, large intestine, (5) __________ , urinary bladder
and the sanjiao (three areas of the body cavity). Zang and fu are classified by the
different features of their functions. The five zang organs mainly manufacture and (6)
__________ essence: qi, blood, and body fluid. The six fu organs mainly receive and
digest food, absorb nutrient substances, transmit and (7) __________ wastes. As the
Suwen says: The five zang organs store up essential qi and regulate its outflow. The six
fu organs transform and transport substances without storing them and for this reason
they may be over-filled but cannot be (8) __________ to capacity.
There is another category of organs called the (9) __________ fu organs which
include the brain, marrow, bone, vessels, gall bladder, and uterus. They are named fu
but their (10) __________ are similar to that of the five zang organs. Since their
physiological functions and pathological changes are closely connected with the zang-fu
organs they will be discussed under the specific zang or fu organ.
Gall Bladder
The gall bladder is attached to the liver and stores bile. There is an ancient saying
regarding the close relationship between the liver and bile, "The remaining qi of the liver
flows to the gall bladder and turns into the juice of essence (bile)." Bile is continuously
excreted into the intestinal lumen to assist in digestion. The bitter taste and yellow color
of bile are significant in disease manifestations of bitter taste in the mouth, vomiting of
bile, jaundice, etc. As the liver and the gall bladder are externally and internally related,
the gall bladder is also involved in the free flow of qi concerning emotional activities.
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Clinically, when some mental disorders or emotional symptoms such as fear and
palpitation, insomnia, dream disturbed sleep, etc. occur, treatment can be applied by
considering the gall bladder.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
The Fu Organs
The fu organs are the receptor organs. These hollow organs receive the fluids and
energies from their zang counterparts. They receive, digest, absorb, and transmit
nutrients and excrete wastes. They are considered yang relative to their paired zang
organ. We can generalize and say that the fu organs transform and transmit. There are
six fu organs: they are the Small Intestines, Stomach, Large Intestines, Urinary Bladder,
Gall Bladder, and an interesting one called the "San Jiao," also known as the Triple
Burner.
The Small Intestines: Paired with the Heart, the Small Intestines receive and store
water and food. Just as we understand in the West, the Small Intestines are believed to
digest food, convert it into nutrition, and send the unusable bits downward for excretion.
A Chinese doctor would call the bits for excretion "turbid" and the nutritious bits "clear."
If we are suffering from too much heat or too much dampness, problems may arise in
our urinary system and turbidity will increase.
The Stomach: Paired with the Spleen, the Stomach receives and digests food. It also
stores food and water. If Stomach Chi is weak, food stagnates and all manner of
digestive problems arise.
The Large Intestine: Paired with the Lungs, the Large Intestines compact our solid
wastes. Just as the Lungs' Chi energy controls water, the Large Intestines also affect
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water through the ability to absorb it. Too little absorption and we suffer loose bowels,
too much and we become constipated.
The Urinary Bladder: Paired with the Kidneys, the Urinary Bladder stores and excretes
urine. If there are problems with Kidney Chi, this may show up in urinary problems such
as frequent micturition or the need to get up at night many times to urinate.
The Gall Bladder: Paired with the Liver, the Gall Bladder stores and excretes bile. In
Chinese medicine, bile is considered to be Liver Chi, not the byproduct of the liver's
digestion of fats, as we believe in the West. Together with the Liver, the Gall Bladder
builds and controls the blood and our overall Chi levels. When weak, the Gall Bladder
may cause us to be indecisive or hesitant. When strong, the Gall Bladder allows us to
be decisive and bold.
The San Jiao: This organ has no Western counterpart. Sometimes referred to as the
Triple Burner, this organ's function relates to digestion and elimination overall. There are
many different views of what the San Jiao is exactly and what it does. It is often
considered to have three separable functions:
 The Upper Jiao, located above the diaphragm, distributes water in a mist form
throughout the body, assisting the Heart and Lungs
 The Middle Jiao, located between the diaphragm and the navel, assists the
Stomach and Spleen with digestion and the transportation of nutrients
 The Lower Jiao, located below the navel, assists the Kidneys and Urinary
Bladder in their roles of elimination
Sometimes the San Jiao is believed to be paired with the Pericardium, which in some
models is considered to be a zang organ separate from the Heart.
Questions
1. How many fu organs are there?
______________________________________________________________________
______________________________________________________________________
2. What are the Small Intestines believed to do?
______________________________________________________________________
______________________________________________________________________
3. What happens to our body when we get too little or too much absorption?
______________________________________________________________________
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______________________________________________________________________
4. What may happen if there are problems with Kidney Chi?
______________________________________________________________________
______________________________________________________________________
5. What is bile considered in Chinese medicine?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
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UNIT
QI, BLOOD AND BODY

5 FLUID
Overview
Qi, blood and body fluid, the essential substances for life activities, flow constantly
inside the body and all originate from the viscera. They are produced by qi-transforming
activities of the viscera and infused into the viscera to nourish the organs and tissues of
the body.
Among the three, qi is the most active but invisible substance while blood and body fluid
are visible, but must depend on the propelling action of qi to circulate in the whole body.
A. QI
I. Introduction
Qi is the most essential substance that makes up the body and maintains life activities.
All vital substances in the body are transformed by constant motion and change of qi.
The viscera, the meridians, the five sensory organs, the nice orifices and the body itself
are formed by the motion, transformation and accumulation of qi.
The production of qi
Qi exists right after the formation of individual life. This kind of qi is inherited from
kidney-qi of the parents during pregnancy. So it is called “congenital qi” which is the
foundation of the development of new life. After birth, the human body keeps absorbing
nutrients from the external world to nourish the congenital qi. This is acquired source of
qi, also known as “acquired qi”. Acquired qi originates from food nutrients and fresh air
inhaled into the body. In fact, the ―congenital qi‖ and ―acquired qi‖ are just two material
sources of qi. The process of qi production also involves the other viscera. The inter-
transformation among essence, qi, blood and body fluid influences the production of qi.
II. THE PHYSIOLOGICAL FUNCTIONS OF QI
Qi is the essential substance that makes up the body and maintains various
physiological activities. Qi in different viscera and organs functions differently. Generally
speaking, there are five physiological functions of qi.
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1. Propelling function
The propelling function of qi can stimulate and maintain the physiological functions of
the viscera and other organs. That is why qi is called the root of life. Qi in different
viscera and organs functions differently. For example, kidney-qi promotes the
development of the body and reproduction, transforms water and receives lung-qi;
heart-qi promotes blood circulation; lung-qi governs respiration and regulates water
passage; spleen –qi promotes digestion and absorption of food and commands blood;
liver-qi regulates various functions by smoothing the activity of qi. Weakness of qi in
promotion will lead to hypofunction of the viscera and other organs and cause various
deficiency problems.
2. Warming function
Qi warms the body and is the source of heat energy in the body. It is very important in
maintaining normal body temperature and ensuring the physiological functions of all
viscera and organs. Since qi can warm the body, it is similar to yang in nature. So the
kind of qi that warms the body is called “yang-qi”. All the five zang-organs have yang-
qi respectively. For example, the heart-yang warms and dredges blood vessels to
promote blood circulation; lung-yang warms and nourishes skin and muscular
interstices, preventing exogenous pathogenic factors from invading the body. If the
warming function of qi is weakened, it will lead to stagnation of internal cold, unsmooth
circulation of qi and blood and devitalization of the visceral functions.
3. Protecting function
Qi can protect the body, resisting the invasion of various pathogenic factors and
preventing disease. As to pathogenic factors, the kind of qi that protects the body is
called ―healthy qi‖ or ―genuine qi‖. Healthy qi functions to protect the whole body against
the invasion of pathogenic factors into the body or onset of disease, to fight against the
pathogenic factors to promote healing of disease. If the protecting function of qi is
weakened, it mainly leads to decline of body resistance and susceptibility of the body to
invasion of pathogenic factors.
4. Fixating function
Fixation of qi means that qi can astringe and control liquid substances, such as blood,
body fluid and sperm, to prevent them from losing. To be specific, qi fixating blood
means that qi keeps blood to flow inside the vessels and prevent it from flowing out of
the vessels; qi fixating sweat, urine and saliva means that qi controls the secretion and
excretion of these liquids so as to restrict the excretion and prevent loss; qi fixating
sperm means that qi balances sex function and prevent seminal emission. If the fixating
function of qi is weakened, it will lead to loss of blood, body fluid and sperm. The
weakness of the qi fixation may also result in protracted diarrhea, incontinence of urine
and stool as well as proctoptosis and hysteroptosis.
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5. Qi transforming function
Qi –transformation means changes caused by the movement of qi, which is the
essential cause of the conception, development, growth and decline of life. Life activities
concerned with qi-transformation can be divided into three categories. Firstly, through
food and respiration, the body absorbs nutrients from the external world and transform
them into essence, qi, blood and body fluid essential to the body. Secondly, inter-
promotion among the refined substance (essence, qi, blood and body fluid, etc,) is the
process of automatic regulation, improvement and balance of life. If qi-transformation is
weakened, the whole process of life will be in disorder or decline, leading to various
diseases. The declination of qi-transformation even leads to death.
B. BLOOD
I. Introduction
Blood, mainly composed of the nutrient qi and body fluid, circulates inside the vessels. It
is red in color and sticky in texture. Blood functions to nourish and moisten the body. It
is vital to the maintenance of life.
The production of blood
The basic substance for producing blood is essence, including the congenital essence
(kidney-essence) and the acquired essence (food nutrients). The congenital essence is
prerequisite to the production of blood. Only when the acquired essence has combined
with the congenital essence can blood be produced. Thus deficiency of kidney-essence
will make it difficult to produce blood. However, the congenital essence is already fixed
after birth. In this case, the acquired essence plays a key role in the production of blood.
For this reason, the functions of the spleen and stomach are key to the production of
blood. If the spleen and stomach are normal in functions, they can absorb sufficient food
nutrients to produce blood. If the spleen and stomach are weak in absorbing food
nutrients, the production of blood is inevitably reduced.
II. The physiological functions of blood
The physiological functions of blood are to nourish and moisten the body. Since blood
contains the nutrient qi, it can nourish all the organs in the body. Through the meridians,
blood transports nutrient substances to all parts of the body to nourish the five zang-
organs, the six fu- organs, the five constituents, the five sensory organs and the nine
orifices. It should be noted that blood is also the important material base for mental
activities. If blood is sufficient, there will be sufficient vitality; if blood is deficient, there
will be dispiritedness; if blood is in disturbance, there will be mental disorder. Since
blood contains fluid, it can moisten the viscera and the body. When the fluid flows out of
the vessels, it moistens the orifices and lubricates the joints.
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Besides, blood also transports the turbid qi. When the turbid qi is transported to the
lung, it is excreted from respiration. When it is transported to the kidney, it is discharged
from urination. When it is transported to the superficies, it is excreted from sweating.
III. The circulation of blood
The vessels in the whole body form a relatively close circulatory system for blood
circulation. Such a system is known as blood vessels in traditional medicine included in
the concept of meridians and vessels. The minute capillaries are called blood
collaterals.
Blood is propelled by the heart to circulate in the vessels. In fact, the heart is the center
of the blood circulatory system. In structure, the heart is connected with the vessels.
That is why the heart can propel blood to circulate in the vessels. Since the circulation
of blood is a circulatory process, the directions of blood circulation is either centrifugal
or axopetal. The former means that the blood is propelled by heart-qi to flow out from
the heart to the whole body through large vessels into large collaterals and fine
capillaries. In such a way blood enters the internal organs to nourish and moisten the
body. The latter means that blood accumulates from the fine capillaries to the large
collaterals and the vessels into the heart under the propelling action of the heart.
The factor that directly acts on blood circulation is qi. For example, heart-qi propels
blood to circulate; lung-qi assists the heart to propel blood circulation; spleen-qi
commands blood; and liver-qi regulates the circulation of blood by dredging and
dispersing qi. Besides, visceral yang also plays an important role in the circulation of
blood. For example, deficiency of yang will inevitably cause deficiency of qi, making it
difficult for blood to circulate; deficiency of yin will bring on cold and exuberant cold will
coagulate blood.
Other factors that may affect blood circulation are the state of the vessels, and the
changes of cold and heat. Generally speaking, phlegm, dampness, blood stasis,
swelling and nodules can block or compress the vessels and obstruct blood circulation.
Blood is characterized by preference for warmth and aversion to cold. So excessive
cold slows down the circulation of blood or even causes blood stasis; excessive heat
accelerates blood circulation and even leads to bleeding in severe cases.
C. BODY FLUID
I. Introduction
Body fluid is a basic substance that makes up the body and maintains life activities. The
main component of body fluid is water, also including nutrient substance. Body fluid is
also a component of blood when it flows inside the vessels. However, body fluid also
flows outside the vessels in the viscera and the body. If secreting or excreting from the
five sensory organs and the nine orifices, body fluid becomes urine, sweat, tears,
69
snivel, saliva and drool, etc. Traditional medicine believes that these five kinds of
liquids including sweat, snivel, tear, saliva and drool also known as spittle are
transformed by the five zang-organs. The relationships between the five zang-organs
and the five kinds of liquids are described this way: sweat is the liquid of the heart,
snivel is the liquid of the lung, tear is the liquid of the liver, saliva is the liquid of the
spleen and drool or spittle is the liquid of the kidney.
Body fluid can be divided into two parts: thin fluid and thick fluid which are different from
each other in property, location and functions. Generally speaking, thin fluid flows
quickly and is distributed in the skin, muscles and orifices to moisten the related parts of
the body. The thick fluid relatively flows slowly and is distributed in the viscera, cerebral
marrow and joints to nourish the related parts of the body. Though different in texture
and distribution, both the thin and thick fluids come from food and water transformed by
the spleen and stomach functionally flowing inside and outside the vessels to permeate
and supplement each other. Physiologically they are not strictly separated from each
other; pathologically ―impairment of the thin fluid‖ is relatively light while ―loss of the thick
fluid‖ is relatively serious.
The production of body fluid
The digestive and absorbing functions of the stomach, the spleen and the large and
small intestines play a key role in the production of body fluid. Body fluid comes from
food, especially water and liquid diet. The production of body fluid comes through a
series of physiological activities, including the functions of the stomach to receive and
digest, the functions of the spleen to transport, transform and transmit, the functions of
the small intestine to receive and digest, and the functions of the large intestine to
transmit and change. Different viscera may exert different effect on the water taken into
the body. So the metabolism of body fluid is accomplished under the coordination of
different viscera.
II. THE PHYSIOLOGICAL FUNCTIONS OF BODY FLUID
The physiological function of body fluid includes the following three aspects:
1. Moistening and nourishing
Body fluid contains large quantity of water and nutrition substances to moisten and
nourish the viscera and the body. To be specific, the thin fluid, distributed in the skin
and orifices, mainly functions to moisten the body; the thick fluid, distributed in the
viscera and cerebral marrow, mainly functions to nourish the body.
2 The transformation of blood
Body fluid not only flows outside the vessels, but also inside the vessels to participate
in the production of blood. Blood is composed of two parts: body fluid and the nutrient
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qi. If body fluid is insufficient, the production of blood will be reduced, leading to blood
deficiency.
3. The transportation of the turbid qi
Body fluid can hold various turbid qi and waste materials produced by qi-transformation
and transport them to the concerned organs to be excreted out of the body through
urination, sweating and respiration. The waste materials and turbid qi are directly
excreted in the form of fluid through urination and sweating. But the turbid qi excreted
through respiration is transported to the lung first by body fluid and then exhaled out of
the body. If body fluid is insufficient, the turbid qi cannot be quickly excreted out of the
body, seriously affecting qi-transformation and causing various pathological changes.
D. THE RELATIONSHIPS AMONG QI, BLOOD AND BODY FLUID
Qi, blood and body fluid are the basic substances that maintain life activities. These
three substances can transform into each other through qi-transforming activity and
depend on each other in physiological functions. If one of them has changed, the other
two will make corresponding reactions. Such an inter-dependent relationship among
them is not only signified in physiology, but also in pathology. Clinically the regulation of
this inter-dependent relationship among qi, blood and body fluid is very important in
treating diseases.
PRACTICE
I. Write the nouns of the following verbs in the table below.

1 Acquire
2 Fix
3 Infuse
4 Inherit
5 Invade
6 Nourish
7 Prevent
8 Promote
9 Resist
10 Stagnate
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II. Choose the best answer to complete each of the following sentences
1. Qi, blood and body fluid, the essential substances for life activities, flow constantly
inside the body and all ___________ originate from the viscera.
A. originates B. originate C. originating D. originated
2. Qi warms the body and is the source of ___________ heat energy in the body. It is
very important in maintaining normal body temperature and ensuring the physiological
functions of all viscera and organs.
A. heat energy B. cold energy C. triple energizer D. warm energy
3. The physiological functions of blood are to ___________ and moisten the body.
Since blood contains the nutrient qi, it can nourish all the organs in the body.
A. nutrition B. nutrients C. nourish D. innutrition
4. The main component of body fluid is water, also including ___________ substance.
A. nutrition B. nutrient C. nourishment D. innutrition
5. Body fluid can be divided into two parts: thin fluid and thick fluid which are different
from each other in property, ___________ and functions.
A. structure B. characteristic C. colour D. location
6. The thick fluid relatively flows slowly and is distributed in the viscera, ___________
marrow and joints to nourish the related parts of the body.
A. cerebral B. cranial C. bone D. spinal
7. The digestive and ___________ functions of the stomach, the spleen and the large
and small intestines play a key role in the production of body fluid.
A. absorb B. absorbing C. reabsorb D. reabsorbing
8. Different ___________ may exert different effect on the water taken into the body.
A. organs B. viscera C. viscus D. Both A and B
9. Body fluid contains large ___________ of water and nutrition substances to moisten
and nourish the viscera and the body.
A. quantity B. quality C. amount D. Both A and C
10. Blood is ___________ two parts: body fluid and the nutrient qi.
A. composed of B. made of C. consisted of D. including
1. Qi is most essential substance that makes up the body and maintains life
A B C D
activities.
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2. Qi can protect the body, resisting the invasion of various pathogenic factors and
A B C
prevent disease.
D
3. Blood, mainly composes of the nutrient qi and body fluid, circulates inside the
A B C D
vessels.
4. The basis substance for producing blood is essence, including the congenital
A B C
essence (kidney-essence) and the acquired essence (food nutrients).

D
5. The vessels in whole body form a relatively close circulatory system for blood
A B C D
circulation.
6. Blood is characterized as preference for warmth and aversion to cold.

A B C D
7. Body fluid is a basic substance that makes up the body and maintain life activities.
A B C D
8. Body fluid is also a component of blood while it flows inside the vessels.
A B C D
9. General speaking, thin fluid flows quickly and is distributed in the skin, muscles and
A B C
orifices to moisten the related parts of the body.
D
10. The metabolism of body fluid is accomplishing under the coordination of different
A B C D
viscera.
IV. Give the right form of the word in bracket to complete each of the following
sentences.
1. Qi–transformation means changes caused by the movement of qi, which is the

___________ cause of the conception, development, growth and decline of life.
(essentiality)
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2. If blood is sufficient, there will be sufficient ___________; if blood is deficient, there
will be dispiritedness; if blood is in disturbance, there will be mental disorder. (vital)
3. Generally speaking, phlegm, dampness, blood stasis, swelling and nodules can block
or ___________ the vessels and obstruct blood circulation. (compression)
4. The relationships between the five zang-organs and the five kinds of liquids are
___________ this way: sweat is the liquid of the heart, snivel is the liquid of the lung,
tear is the liquid of the liver, saliva is the liquid of the spleen and drool or spittle is the
liquid of the kidney. (description)
5. The production of body fluid comes through a series of physiological activities,

including the functions of the stomach to receive and digest, the functions of the spleen
___________ , transform and transmit, the functions of the small intestine to receive
and digest, and the functions of the large intestine to transmit and change.
(transportation)
6. Body fluid not only flows outside the vessels, but also inside the vessels
___________ in the production of blood. (participation)
7. The waste materials and turbid qi are ___________ excreted in the form of fluid
through urination and sweating. (direct)
8. Qi, blood and body fluid are the basic substances that maintain life activities. These
three substances can transform into each other through qi-transforming activity and
depend on each other in physiological functions. If one of them has changed, the other
two will make ___________ reactions. (correspond)
9. If body fluid is ___________ , the turbid qi cannot be quickly excreted out of the body,
seriously affecting qi-transformation and causing various pathological changes.
(sufficiency)
10. ___________ the regulation of this inter-dependent relationship among qi, blood
and body fluid is very important in treating diseases. (Clinic)
Qi- Blood, Body Fluids, Essence
importance protect external vital is
warm blood skin reproductive contains
The body (1) __________ a mini eco-system according to Traditional Chinese

Medicine (TCM). The environment and the body are similarly viewed in the Chinese
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culture. There are (2) __________ substances contained on earth that are vital to the
earth‘s survival such as the air, water, and land. The human body being similar also has
vital substances – (3) __________ , body fluids, essence and Qi.
Blood: No one can deny the (4) __________ of blood to the survival of the body. It is
needed for bone, organ creation, skin and muscle. The Chinese also believe that blood
(5) __________ Shen (spirit) that gives balance to the psyche.
Body Fluids: The Chinese call body fluids Jin Ye. Body fluids (6) __________ ,
lubricate and care for the body alongside the blood. Body fluids give needed moisture to
our (7) __________ , muscles and also the joints to help them function properly. Fluids
are also important to our spine, bone marrow and our brain. When we become
dehydrated the skin becomes dry and flaky, bowels become constipated. When bodies
have too much fluids individuals become lethargic and can have an increase in phlegm.
Essence: Jing is what the Chinese people call essence. Essence is the body‘s (8)
__________ and regenerative substance. The body‘s growth, development,
reproductive system all is regulated by essence. Essence also works with qi to protect
the body from (9) __________ causes that try to harm the body.
Qi: That very special energy that we all have that allows us to move, feel and think is
called, qi. Qi is what protects us from illness, and keeps our body (10) __________ .
There are two ways that our body receives qi. We receive qi from the air we breath and
from the food we eat. When the supply of qi is blocked or depleted below compatible
levels with functioning, organs fail and illness sets in.
The Concept of Qi
Qi is the most basic substance of which the world is comprised. Everything in the
universe results from the movements and changes of qi.
Two aspects:
- The vital substances comprising the human body and maintaining its life activities (qi
of food essence, qi of breathing).
- The physiological functions of viscera and bowels, channels and collaterals (qi of the
heart).
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Vital Substances
These very important vital substances flow through the body nourishing it, supporting it
and maintaining it. The body is in a healthy state when all of the vital substances are
present in appropriate amounts. When any of the vital substances are depleted or
absent, the body can become unhealthy and symptoms such as aches, tension,
swelling, indigestion, and fatigue can occur.
The substances flow through meridians that are positioned to link all of the body parts
together. Meridians are very important to Chinese therapy. It is through these meridians
that therapy can adjust or regulate qi.
Getting back to our mini eco-system, these meridians are vital as they transport the vital
substances to where the body needs them. Just as rivers flow to provide moisture for
plants and animals, meridians flow to provide moisture and qi to the body.
The vital substances are necessary for good health. Chinese medicine is focused on
regulating qi and monitoring these vital substances.
Questions
1. When is the body in a healthy state?
______________________________________________________________________
______________________________________________________________________
2. What happens to the body when any of the vital substances are depleted or absent?
______________________________________________________________________
______________________________________________________________________
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3. Getting back to our mini eco-system, why are these meridians vital?
______________________________________________________________________
______________________________________________________________________
4. What is the relationship between the vital substances and our health?
______________________________________________________________________
______________________________________________________________________
5. What is Chinese medicine focused on?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
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UNIT
ETIOLOGY
6
Overview
Etiology or causes of disease refers to various pathogenic factors, the differentiation of
which decides the differentiation of syndromes, the cognition of disease and the
selection of correct therapeutic methods. In fact, the treatment of disease in traditional
medicine is causal treatment and the differentiation of syndromes, to a large degree, is
causal differentiation of syndromes, known as ―differentiation of syndromes to find
causes‖, ―analysis of symptoms to find causes‖ and ―analysis of causes to decide
treatment‖.
Disease means the damage of health. Traditional medicine believes that the healthy
state implies the balance of yin and yang, the manifestation of which is high
coordination and unity between the viscera, the meridians, qi, blood and body fluid as
well as the body and the external environment. If such a state of high coordination and
unity is broken by various pathogenic factors, disease will be caused. The occurrence of
disease is actually concerned with pathogenic factors and healthy qi (body resistance).
Besides, constitution is also an important factor responsible for the occurrence of
disease.
The pathogenic factors in traditional medicine can be divided into four categories:
- Exogenous pathogenic factors including six climatic factors and pestilence
- Endogenous pathogenic factors including seven emotions, improper diet, overwork and
over-rest
- Secondary pathogenic factors including phlegm and blood stasis
- Other pathogenic factors including various traumatic injuries, injuries due to physical
and chemical factors, and injuries caused by insects and animals.
A. EXOGENOUS PATHOGENIC FACTORS

The Six Climatic Factors
The six climatic factors are pathogenic wind, pathogenic cold, pathogenic summer-heat,
pathogenic dampness, pathogenic dryness and pathogenic heat (fire).
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Wind, cold, summer-heat, dampness, dryness and heat (fire) are six kinds of natural
climatic factors known as ―six-qi‖. Human beings living in the natural world constantly
contact with these natural factors. Under normal condition, the human body can adapt
to the changes of climate which are indispensable to the existence of human beings. If
the harmonious relationship between human beings and nature is broken, the body is
unable to adapt itself to the changes of the climate, leading to the occurrence of
disease. Under such as a condition, these six natural climatic factors become
pathogenic factors.
The six climatic factors are characterized by the following features in causing disease:
1. The cause of disease by the six climatic factors is usually related to seasonal
changes and living conditions because the occurrence of wind, cold, summer-heat,
dampness, dryness and heat (fire) is specifically related to the four seasons.
2. The six climatic factors may singly or collectively attack people. For example,
pathogenic wind may combine with cold, dampness, dryness and heat to attack people
and lead to wind-cold syndrome, wind-dampness syndrome, wind-dryness syndrome
and wind-heat syndrome.
3. The nature of the diseases caused by the six climatic factors may be the same as or
different from that of the six climatic factors. For example, invasion of pathogenic cold
may deepen internally to transform into heat and accumulation of pathogenic dampness
also may transform into heat.
4. The six climatic factors usually invade people from the ski into the muscles or from
the mouth and nose into the lung and the defensive qi. That is why external syndromes
tend to appear at the early stage of disease caused by the six climatic factors and
gradually transmit to the internal.
Besides, clinically there are some diseases due to dysfunction of the viscera that
appear similar to the pathological changes caused by pathogenic wind, pathogenic cold,
pathogenic dampness, pathogenic dryness and pathogenic heat (fire), known as ―five
endogenous pathogenic factors‖.
Pestilence
Pestilence is a kind of strong infectious pathogenic factor, quite similar to the
pathogenic heat (fire) in the six pathogenic factors in nature, but more serious than the
pathogenic heat in toxicity. The diseases caused by pestilence are marked by acute
onset, severe pathological condition, similar symptoms, strong infection and easiness to
spread. Historical records show that diseases caused by pestilence often spread the
disease far and wide with high mortality.
The commonly encountered diseases caused by pestilence are facial erysipelas,
mumps, pestilent dysentery, diphtheria, scarlet fever, smallpox, cholera and plague.
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B. ENDOGENOUS PATHOGENIC FACTORS
Internal impairment due to seven emotions
The seven emotions refer to joy, anger, anxiety, contemplation, grief, fear, and terror
which are different responses of the body to the environmental stimuli and are normal
psychological activities. Normally, the seven emotions will not cause disease, but
sudden, violent or prolonged emotional stimuli, beyond the range of physiological
activities, will cause disorder of qi activity and disharmony of visceral yin, yang, qi and
blood and the internal disorder caused is called ―internal impairment due to seven
emotions‖.
The seven emotions are the physiological responses of visceral qi, blood, yin and yang.
Different visceral qi, blood, yin and yang differ from each other in moving styles, leading
to different emotional responses. The seven emotions are matched with the five viscera:
the heart governs joy, the liver governs anger, the spleen governs contemplation, the
lung governs grief, and the kidney governs fear. Terror and anxiety are also closely
related to the activity of qi in the five zang-organs.
Since the seven emotions are endogenous, they can directly impair the internal organs.
For example, excessive joy impairs the heart, excessive anger impairs the liver,
excessive contemplation impairs the spleen, excessive grief impairs the lung, and
excessive fear impairs the kidney, etc. The relationships among the five zang-organs
are complicated, so the impairment of one viscus by the seven emotions may involve
several zang-organs and fu-organs. For example, depression and rage impair the liver.
But the adverse flow of liver-qi often attacks the spleen and the stomach, leading to the
imbalance between the liver and the spleen as well as disharmony between the liver
and the stomach. Since the heart is the supreme dominator of the mental activities, the
impairment caused by the seven emotions is closely related to the heart. Clinically the
seven emotions often impair the heart, the liver and the spleen.
When the seven emotions impair the internal organs, they mainly affect the activity of
visceral qi, leading to disorder of the activity of qi, and in turn, bringing on the disorder of
blood circulation because the blood flows together with qi. Prolonged emotional upset
may transform into fire known as ―transformation of five emotions into fire‖, resulting in
disharmony between yin and yang because fire consumes yin.
Emotional factors can cause certain diseases. For example, people with frequent
superabundance of liver-yang tend to flare into violent rage which brings on violent
hyperactivity of liver-yang, leading to sudden dizziness and syncope or
unconsciousness, paralysis and distorted face. Besides, certain diseases may become
aggravated or worsened because of abnormal changes of emotions. For example, the
heart disease can be caused and quickly worsened by sudden terror.
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Improper diet
Diet is indispensable to human existence and is the main route for human being to
obtain nutrient substances from the natural world. However, the intake of food has to
follow certain rules. If the diet is improper, it may impair the body and become
pathogenic factors. Improper diet includes three aspects: starvation and overeating,
unhygienic food and food partiality.
Starvation and overeating
Starvation refers to two different things: prolonged lack of food and protracted
insufficient intake of food. Prolonged lack of food cannot provide the body with enough
nutrient substance, leading to insufficient production of qi and blood and sudden decline
of the visceral functions and with the manifestations of dizziness and lassitude of the
four limbs or even death in severe cases. Protracted insufficient intake of food will lead
to malnutrition, deficiency of qi and blood, weakness of the body, susceptibility to
invasion of pathogenic factors and various diseases.
Overeating means two things: crapulence and protracted excessive intake of food.
Crapulence impairs the spleen and stomach because the food taken is beyond the
normal functions of the spleen and stomach to digest, transport, and transform, leading
to gastric and abdominal distension and fullness, eructation with fetid, and acid odor,
anorexia, vomiting and diarrhea. Protracted excessive intake of food will bring on
supernutrition, delayed transformation of qi and failure of the nutrients of food and water
to transform into qi and blood. Instead, the nutrients and water turn into phlegm and
accumulate in the body to hinder the flow of qi and blood, leading to obesity, dizziness,
palpitation and chest oppression, or transforming dampness into heat to invade the
vessels and causing abscess, carbuncle, sores and ulcers.
Unhygienic food
If food contains unhygienic elements, it will cause diseases. Usually, unhygienic food
can cause gastrointestinal disorders, such as abdominal pain, vomiting and diarrhea. If
food is contaminated with parasitic ovum, it will cause various parasitic diseases. Putrid
food is poisonous and can cause abdominal pain, vomiting and diarrhea if it is taken.
Food partiality
Normally people should take a variety of food in proper proportions in order to ensure a
balanced nutrition. Protracted food partiality leads to insufficient intake of certain
substances and excessive intake of other substances which will cause imbalance
visceral qi, blood, yin and yang.
Overwork and over-rest
Work and rest are two activities indispensable to human existence. Normal work is
helpful for the flow of qi and blood and strengthening the body. Necessary rest can
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eliminate fatigue and restore strength and vitality. Overwork and over-rest all lead to
disease.
Overwork covers three aspects: overstrain, overwork with the mind and excessive
sexual activity. Overstrain refers to protracted physical hard work such as over physical
work and over sports activity. Protracted physical hard work consumes great amount of
qi and blood and causes disease if the energy and vitality are not supplemented and
restored in time. Overwork with the mind refers to excessive contemplation that
consumes heart-blood and causes asthenia disease. Excessive sexual activity
consumes kidney-essence, weakens qi and blood and malnourishes the five zang-
organs, leading to early senility with the symptoms of aching and weakness of the waist
and knees, dizziness and tinnitus, dispiritedness, or impotence, seminal emission and
premature ejaculation due to kidney deficiency.
Over-rest means lack of enough activity. Protracted lack of enough activity will lead to
slow movement of qi and blood, hypofunction of the viscera, poor appetite, fatigue,
dispiritedness, weakness of the four limbs or obesity, intolerance to work, palpitation,
asthma and sweating when moving. Prolonged lack of activity will give rise to the
production of phlegm, dampness, and blood stasis inside the body, and invasion of
pathogenic wind, cold, and dampness from the outside, eventually bringing on various
diseases.
C. SECONDARY PATHOGENIC FACTORS
Phlegm and blood stasis are pathological substances produced during the course of
disease due to certain pathogenic factors. They may directly or indirectly affect the
viscera and the body, leading to secondary disease. So phlegm and blood stasis are
both pathological substances and pathogenic factors. Since they have resulted from
primary disease, they are called secondary pathogenic factors.
Phlegm and rheum
Phlegm is a pathological substance caused by disturbance of body fluid. Generally
speaking, the thick part is called phlegm while the thin part is called rheum.
Rheum is classified into four categories according to their location, namely phlegmatic
rheum in the abdomen, suspending rheum in the chest and diaphragm, sustaining
rheum in the rib-sides and overflowing rheum in the skin and muscles.
Phlegm, rheum and dampness are all pathological substances caused by disturbance of
body fluid. But they are different from each other. The one that spreads and appears
substantial is dampness; the one that accumulates and appears substantial is rheum;
the one that is thin and clear is water; the rheum that is condensed is phlegm. That is to
say all of them result from disturbance of body fluid and can transform into each other.
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Phlegm and rheum can flow everywhere with qi to anywhere If phlegm and rheum flow
in the meridians, they tend to block the meridians and hinder the flow of qi and blood,
leading to numbness and inflexibility of limbs, or even paralysis. If accumulating in local
areas, they frequently causes scrofula, subcutaneous nodules and cold abscess.
Retention of phlegm and rheum in the viscera tends to hinder the activity of qi and
prevent visceral qi from ascending and descending. If phlegm disturbs the upper and
blends lucid yang, it will lead to dizziness; if phlegm confuses the mind or phlegm-fire
disturbs the heart, it will cause chest oppression, palpitation, unconsciousness and
delirium or mania.
Clinically, the diseases caused by phlegm and rheum may involve the five zang-organs
and six fu-organs, the body, the sensory organs, the orifices, the four limbs and the
skeleton. The symptoms are chest oppression, cough, asthma, expectoration, nausea,
vomiting, palpitation, dizziness, mania, numbness of the limbs, arthralgia or swelling of
joints, subcutaneous swelling or suppuration, edema, ascites, and diarrhea. Generally
speaking, obstinate disease and disease without evident cause are all related to phlegm
and rheum. Since phlegm and rheum can ascend and descend with qi, the disease
caused by them is usually marked by constant change and recurrence. Take epilepsy
for example. It attacks when phlegm ascends with qi and stops when phlegm descends
with qi.
Blood stasis
Blood stasis is a kind of pathological substance caused by disturbance of blood
circulation. Normally the blood is propelled by heart-qi to flow in the vessels. If blood
circulation is stagnated or slowed down by certain factors, it will lead to retention of
blood in the vessels or viscera or overflow of blood out of the vessels, causing blood
stasis.
Blood stasis is substantial pathological substance such as clots in the blood ,
subcutaneous purpura or lump in the body. Sometimes blood stasis is insubstantial,
referring to certain symptoms related to blood stasis such as various kinds of pain,
palpitation and mania.
Blood stasis and blood stagnation are two different concepts. The former is a kind of
pathological substance while the latter is a pathological process. The former is the result
of the latter while the latter inevitably leads to the former.
There are various factors responsible for blood stasis. It may be caused by six
exogenous climatic factors. For example, cold stagnates and tends to block blood
vessels. It may be caused by seven emotions. For example, anxiety binds qi and tends
to slow down blood circulation. It may be caused by consumptive disease and
overstrain.
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The manifestations of diseases caused by blood stasis are various. The following are
the common ones:
Pain- It is marked by stabbing, fixed and unpalpable pain that turns worse at night. It is
caused by blood stasis due to protracted disease and deficiency of qi and blood, the
pain is vague and lingering.
Lump - Protracted blood stasis gradually develops into lumps which appear hard and
fixed. If the lumps are subcutaneous, the skin usually turns cyanotic. If the lumps are in
the viscera, hard mass will be caused.
Hemorrhage – Hemorrhage can lead to blood stasis. If blood stasis is retained in the
blood vessels, the impairment caused is very hard to cure and tends to bring on
repeated hemorrhage which can only be stopped by activating blood to resolve stasis to
repair the injured vessels. Hemorrhage caused by blood stasis often appears cyanotic
and accompanied by blood clot.
Cyanosis – The patient with blood stasis is characterized by cyanotic complexion, lips
and nails.
Tongue variations – The tongue is cyanotic or has ecchymosis petechia.
Pulse variations – The pulse is thin, unsmooth, deep and taut, or knotted or slow
regular intermittent. Besides, there are still some other common encountered symptoms
such as blackish complexion, squamous and dry skin, purpura on the skin, amnesia and
mania.
Apart from the points mentioned above, clinical blood stasis is diagnosed with the
consideration of the following points:
- If there are traumatic injury, hemorrhage and history of menstruation, pregnancy
and labor, the patient tends to have internal retention of blood stasis.
- If the treatment is ineffective before the application of the therapy of activating
blood to resolve stasis, the patient must have insubstantial blood stasis though
there are no signs of blood stasis.
- Protracted disease involving the collaterals often causes blood stasis. If it is
lingering, blood stasis has to be taken in to consideration.
The above three points are the supplementary methods for diagnosing blood stasis.
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PRACTICE

1 Analyze
2 Consume
3 Contemplate
4 Differentiate
5 Disturb
6 Eruct
7 Exist
8 Injure
9 Manifest
10 Occur
1. Wind, cold, summer-heat, dampness, dryness and heat (fire) are six kinds of natural
climatic factors ___________ ―six-qi‖.
A. known as B. defined C. called D. Both A and C
2. If the harmonious relationship between human beings and nature ___________, the
body ___________ to adapt itself to the changes of the climate, leading to the
occurrence of disease.
A. is broken / is unable
B. were broken / will be unable
C. had been broken / would have been unable
D. had broken / would be unable
3. The seven emotions refer to joy, anger, anxiety, contemplation, grief, fear, and terror
___________ are different responses of the body to the environmental stimuli and are
normal psychological activities.
A. which B. who C. whom D. whose
4. ___________ diet includes three aspects: starvation and overeating, unhygienic food
and food partiality.
A. Proper B. Improper C. balanced D. Imbalanced
5. Normally people should take a variety of food in proper proportions ___________

ensure a balanced nutrition.
A. so as not to B. so that C. in order to D. in order not to
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6. Overwork covers three aspects: overstrain, overwork with the mind and ___________
sexual activity.
A. regular B. irregular C. moderate D. excessive
7. ___________ is a pathological substance caused by disturbance of body fluid.

A. Lymph B. Phlegm C. Plasma D. Serum
8. There are various factors responsible for blood stasis. It may be caused by six
___________ climatic factors.
A. infectious B. endogenous C. exogenous D. pathogenic
9. If there are traumatic injury, hemorrhage and history of menstruation, pregnancy and
labor, the patient tends to have internal ___________ of blood stasis.
A. retention B. discharge C. stagnation D. obstruction
10. If the ___________ are in the viscera, hard mass will be caused.
A. nodes B. nodules C. clots D. lumps
1. The pathogenic factor in traditional medicine can be divided into four categories.
A B C D
2. Historical records show that diseases caused by pestilence often spreads the disease
A B C D
far and wide with high mortality.
3. The relationships among the five zang-organs are complicated, but the impairment of
A B
one viscus by the seven emotions may involve several zang-organs and fu-organs.
C D
4. Certain diseases may become aggravated or worsened because abnormal changes
A B C
of emotions.
D
5. Without the diet is improper, it may impair the body and become pathogenic factors.
A B C D
6. If food contains unhygienic elements, they will cause diseases.

A B C D
7. Work and rest are two activities which indispensable to human existence.
A B C D
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8. Phlegm and blood stasis are pathological substances producing during the course of
A B
disease due to certain pathogenic factors.
C D
9. Blood stasis is a kind of pathological substance which are caused by disturbance of

A B C
blood circulation.
D
10. The patient of blood stasis is characterized by cyanotic complexion, lips and nails.
A B C D
IV. Give the right form of the wordS in bracketS to complete the following
sentences.
1. Etiology or causes of disease ___________ to various pathogenic factors, the

differentiation of which decides the differentiation of syndromes, the cognition of disease
and the selection of correct therapeutic methods. (reference)
2. Pestilence is a kind of strong infectious pathogenic factor, quite similar to the

pathogenic heat (fire) in the six pathogenic factors in nature, but more serious than the
pathogenic heat in ___________. (toxic)
3. ___________ refers to two different things: prolonged lack of food and protracted
insufficient intake of food. (starve)
4. When the seven emotions ___________ the internal organs, they mainly affect the
activity of visceral qi, leading to disorder of the activity of qi, and in turn, bringing on the
disorder of blood circulation because the blood flows together with qi. (impairment)
5. Usually, ___________ food can cause gastrointestinal disorders, such as abdominal

pain, vomiting and diarrhea. If food is contaminated with parasitic ovum, it will cause
various parasitic diseases. (hygiene)
6. If the treatment is ___________ before the application of the therapy of activating

blood to resolve stasis, the patient must have insubstantial blood stasis though there
are no signs of blood stasis. (effectivity)
7. Phlegm, rheum and dampness are all pathological substances caused by
___________ of body fluid. But they are different from each other. (disturb)
8. Phlegm and blood stasis are both pathological substances and pathogenic factors.
Since they have resulted from primary disease, they are called ___________
pathogenic factors. (second)
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9. ___________ lack of activity will give rise to the production of phlegm, dampness,
and blood stasis inside the body, and invasion of pathogenic wind, cold, and dampness
from the outside, eventually bringing on various diseases. (Prolong)
10. Rheum is classified into four ___________ according to their location, namely
phlegmatic rheum in the abdomen, suspending rheum in the chest and diaphragm,
sustaining rheum in the rib-sides and overflowing rheum in the skin and muscles.
(categorize)
Etiology
clinical maintain disease imbalances natural
symptoms many termed blood stasis relationship
Traditional Chinese medicine posits a uniquely relative (1) __________ between the
zang-fu organs and tissues of the human body, as well as between the human body and
the (2) __________ environment. All are in a relatively balanced state in order to (3)
__________ the body's normal physiological function. When this balance is
destroyed disease results.
Through long term clinical practice, the ancient Chinese realized that there are (4)
__________ factors which may bring about (5) __________ in the human body
and thus disease; climate abnormalities, pestilence, emotional stimulation, injury by
irregular diet or overstrain, trauma, insect-bited, etc., plus pathological products of
disease outcome, such as (6) __________ , phlegm-humor, etc. All of these contribute
to imbalances within the human system.
The etiology of traditional Chinese medicine used (7) __________ manifestations as

evidence, i.e., through the analysis of (8) __________ and signs of a disease, one
can find its causative factors. This is technically (9) __________ "checking
syndromes to find causative factors of a disease." For our study of etiology, we must
concern ourselves with the properties of pathogenic factors and the characteristics of
how and why they cause (10) __________ .
Traditional Chinese medicine holds that the occurrence of a disease not only depends
on exogenous factors, but more importantly is decided by body resistance. Chinese
medicine terms all exogenous pathogenic factors as xie qi, while the body's is relatively
weak, xie qi will have an opportunity to attack and Suwen records, "If a pathogenic
88
factor attacks the body, then the zheng qi must be weak." Furthermore, "When zheng qi
exists in the interior, the pathogenic factor will be unable to interfere."
Therefore the invasion of xie qi is due to the insufficiency of zheng qi, this is the root
cause. Xie qi is necessary condition for the occurrence of a disease. The development,
transformation, and prognosis of a disease depend on the forced balance of zheng qi
and xie qi.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Etiology
Etiology (alternatively aetiology or ætiology) is the study of causation, or origination. The

word is derived from the Greek αἰτιολογία, aitiología, "giving a reason for" ("cause").
More completely, etiology is the study of the causes, origins, or reasons behind the way
that things are, or the way they function, or it can refer to the causes themselves. The
word is commonly used in medicine, (where it is a branch of medicine studying causes
of disease) and in philosophy, but also in physics, psychology, government, geography,
spatial analysis, theology, and biology, in reference to the causes or origins of various
phenomena.
In the past, when many physical phenomena were not well understood or when
histories were not recorded, myths often arose to provide etiologies. Thus, an etiological
myth, or origin myth, is a myth that has arisen, been told over time or written to explain
the origins of various social or natural phenomena. For example, Virgil's Aenead is a
national myth written to explain and glorify the origins of the Roman Empire. In theology,
many religions have creation myths explaining the origins of the world or its relationship
to believers.
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Questions
1. Where is the term ‗etiology‘ originated from?
______________________________________________________________________
______________________________________________________________________
2. How is the term ‗etiology‘ more completely defined?
______________________________________________________________________
______________________________________________________________________
3. In what fields is the term etiology commonly found?
______________________________________________________________________
______________________________________________________________________
4. Why did myths often arise in the past, when many physical phenomena were not well
understood or when histories were not recorded?
______________________________________________________________________
______________________________________________________________________
5. What is mentioned about Virgil's Aenead?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
90
UNIT
DISEASE PATTERNS
7 EIGHT PRINCIPLE PATTERN
IDENTIFICATION
Eight-principle pattern identification: identification of disease patterns by eight

fundamental principles, namely interior and exterior, cold and heat, vacuity and
repletion, and yin and yang. Interior and exterior are the principles of depth of the
disease; cold and heat are the nature of disease; vacuity and repletion are the
weakness of right qi and strength of evil qi. Yin and yang, which embrace the other six
principles, are general categories of disease. Interior, cold, and vacuity are yin, whereas
exterior, heat and repletion are yang. Each principle is associated with specific signs. By
matching the patient‘s signs to them, it is possible to determine (1) the depth and nature
of the disease and (2) the relative strength of the forces that resist disease and those
that cause it. Eight-principle pattern identification is a preliminary organization of
examination data: treatment should be determined only when other methods of pattern
identification have provided a more detailed picture of the patient‘s condition.
Exterior pattern: the manifestation of disease in the exterior of the body, caused by
any of the six excesses entering the body‘s exterior; characterized by sudden onset and
by aversion to cold ( or the milder aversion to wind), heat effesion (fever), headache, a
thin tongue fur, and a floating pulse. Other possible signs are headache, nasal
congestion, and aching pain in the limbs and joints. Distinction is made between exterior
cold, exterior heat, exterior vacuity, and exterior repletion.
Exterior cold: Exterior cold patterns are characterized by pronounced cold signs with a
distinct aversion to cold. The pulse is tight and floating, the tongue fur is thin, white and
moist. ―When cold prevails, there is pain,‖ and in exterior cold patterns, headache and
generalized pain and heaviness are also pronounced. Runny nose with clear snivel
(nasal mucus) and expectoration of clear thin phlegm are common signs. Exterior cold
patterns are caused by contraction of wind-cold evil.
Exterior heat: exterior heat patterns are characterized by pronounced heat signs, such
as a red sore pharynx and a relatively red tongue with dry fur. Other signs include
91
cough and the production of thick white or yellow phlegm. Most exterior heat patterns
are attributable to contraction of wind-heat evil. Note that identification of exterior heat
patterns is based on assessment of heat and cold ―signs‖ rather than the actual body
temperature. Heat effusion (fever) is a sign which does not necessarily correspond to
heat in the sense of the eight principles.
Exterior vacuity: Exterior vacuity patterns with persistent sweating and heat effusion
(fever). Exterior vacuity results from construction-defense disharmony in which the
body‘s resistance to external evils is lowered and, despite sweating, fails to expel the
evil. Such conditions are reflected in a moderate (i.e., not tight) floating pulse.
Exterior repletion: exterior patterns without sweating are exterior repletion patterns. In
most cases, exterior repletion patterns are exterior cold patterns caused by contraction
of exuberant cold evil that obstructs defense qi and blocks the interstices; they manifest
in a tight floating pulse.
Interior pattern: any disease pattern that indicates disease of the interior. (1) any
disease pattern of the bowels or viscera, in contradistinction to externally contracted
heat (febrile) disease, e.g., liver disease characterized by dizziness and rib-side pain;
heart disease characterized by heart palpitations or fearful throbbing; spleen disease
characterized by abdominal distention and diarrhea; and kidney disease characterized
by lumbar pain and seminal emission. (2) in externally contracted heat (febrile) disease,
an interior pattern arises when an evil that has caused an exterior pattern passes into
the interior. Rarely, external evils may strike the interior directly; in most cases, they
pass through the exterior. Hence febrile disease interior patterns are identified when
aversion to wind or cold – which may or may not be accompanied by heat effusion
(fever) or (sweating) – gives way to high fever or tidal heat (effusion), vexation and
agitation, thirst, clouded spirit, abdominal pain or distention, diarrhea or constipation,
short voidings of reddish urine or inhibited urination, dry yellow tongue fur, and a rapid
sunken pulse.
Midstage pattern: half-interior half-exterior pattern: a disease pattern that occurs when
an exterior evil fails to reach the interior and right qi is too weak to fight it. The signs are
alternating (aversion to) cold and heat (effusion), chest and rib-side fullness, heart
vexation, no desire for food and drink, bitter taste in the mouth, dry pharynx, dizzy
vision, and stringlike pulse. The etiology of midstage patterns is considered in detail
under lesser yang disease.
Cold pattern: any disease pattern characterized by cold signs such as aversion to cold,
a somber white or green-blue facial complexion, slow or tight pulse, not thirst or desire
for warm fluid, and long voidings of clear urine. It is attributed to exuberant yin evil or to
yang vacuity. (1) Prevalence of yin due to an exuberant yin evil accounts for
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pronounced cold signs such as abdominal pain, fulminant (i.e., sudden and violent)
vomiting or diarrhea, green-blue facial complexion, and a tight pulse. (2) Yang vacuity
accounts for signs more commonly encountered in clinical practice, such as liking for
quiet, curled-up lying posture, long voidings of clear urine, clear-grain diarrhea,
conterflow cold of the limbs, and a slow pulse.
Heat pattern: any disease pattern characterized by heat signs. Heat patterns arise
when a yang evil invades the body or when yin humor becomes insufficient. Thus, heat
patterns are caused by a surfeit of yang or a deficit of yin, which form repletion heat or
vacuity heat patterns, respectively. Repletion heat patterns are characterized by red
complexion, red eyes, vigorous heat (effusion), agitation, thirst, desire for cold fluids,
hard stool, short voidings of reddish urine, a red or crimson tongue with a yellow fur,
and a rapid pulse or a rapid large surging pulse. Vacuity heat patterns are marked by
vexing heat in the five hearts (palms, soles, and chest), steaming bone tidal heat
(effusion), dry throat and mouth, smooth bare red tongue (mirror tongue), and a fine
rapid pulse.
Vacuity pattern: any disease pattern caused by weakness of the body‘s forces and
absence of an evil. Vacuity patterns are attributed to insufficiencies of qi, blood, yin, and
yang that arise from damage to right qi either through enduring illness, loss of blood,
seminal loss, and great sweating, or by invasion of an external evil (yang evils readily
damage yin humor and yin evils readily damage yang qi), constitutional weakness, or
the wear and tear that comes with age. Since these insufficiencies frequently affect
specific bowels or viscera, further distinction is made between such forms as heart yin
vacuity liver blood vacuity, kidney yang vacuity, lung qi vacuity, etc.
Vacuity detriment: any form of severe chronic insufficiency of yin-yang, qi-blood, and
bowels and viscera that arises through internal damage by the seven affects, taxation
fatigue, diet, excesses of drink and sex, or enduring illness.
Vacuity taxation: any pattern of severe vacuity (of qi, blood, bowels, or viscera),
including notably steaming bone and consumption.
Repletion pattern: any condition in which the presence of an evil is resisted by the
body; the opposite of vacuity pattern. Repletion patterns are attributed to external evils,
water-damp, phlegm-rheum, static blood, worm accumulations, or food accumulations.
They reflect the nature of the evil (e.g., cold being characterized by pale or green-blue
compexion, clear thin cold fluids), and the location (e.g., stomach disease being marked
by vomitting, belching, etc., or exterior disease being characterized by heat effusion
(fever), aversion to cold, and sweating). Most importantly, however, there are signs of
right qi fighting the evil, such as pulses that are forceful at the deep level (e.g., rapid
93
surging pulses, slippery stringlike pulses, and large replete pulses), pain or discomfort
that refuses pressure, and sudden onset of disease.
Yin pattern: interior, cold, and vacuity patterns. Commonly observed signs include pale
complexion, generalized heaviness, curled up lying posture, physical cold and cold
limbs, fatigue and lack of strength, timid low voice, bland taste in the mouth, absence of
thirst, fishy-smelling food, short voidings of clear urine, pale tender-soft enlarged
tongue, and sunken slow pulse that may be weak or fine and rough.
Yang pattern: exterior, heat and repletion patterns. Commonly observed signs include
red complexion, aversion to cold and heat effusion, schorching hot skin, vexed spirit,
rough turbid voice, abnormal chiding and cursing, rough breathing, hasty painting and
phlegm rale, dry mouth with thirst and intake of fluid, dry bound stool, rough painful
urination, short voidings of red urine, red or crimson tongue with yellow or black fur or
with prickles, and a pulse that is floating and rapid, large and surging, or slippery and
replete.
Yin vacuity: the manifestation of insufficiency of the yin aspect and depletion of liquid
and blood. When yin is vacuous, internal heat arises; hence there is low fever, heat in
the hearts of the palms and soles, postmeridian heat effusion, emaciation, night
sweating, dry mouth and throat, short voidings of reddish urine, red tongue with little or
no fur, and a forceless fine rapid pulse. Yin vacuity may be focused in any of the five
viscera, especially in the kidney.
Yang vacuity: the manifestation of insufficiency of yang qi; reduction in the warming
and activating power of the body. Signs include fatigue and lack of strength, shortage of
qi and laziness to speak, fear of cold, cold limbs, spontaneous sweating, pale white
complexion, long voidings of clear urine, sloppy stool, pale tender-soft tongue, and a
large vacuous or faint fine pulse. Yang vacuity is treated by warming yang and boosting
qi.
Yin collapse: also called yin desertion and fulminant desertion of yin humor, a critical
pattern of wearing of yin-blood. The chief signs are copious sweat, palpably hot skin,
and warm limbs or reversal cold of the limbs with heat in the hearts of the soles and
palms. Other signs include agitation or, in severe cases, clouded spirit on the one hand
and desire for cool fluids on the other. Breathing is short and hasty with difficulty
catching the breath. The tongue is dry and red, whereas the pulse is weak and rapid.
Yin desertion: yin collapse
Fulminant desertion of yin humor: yin collapse
94
Yang collapse: also called yang desertion. A disease pattern of critical debilitation of
yang qi marked by sweating and cold skin and by reversal cold of the limbs. The patient
is apathetic or (rarely) agitated, and in severe cases his spirit is clouded. Either there is
no thirst or there is a desire for warm fluids. The pulse is either hidden, sunken, fine,
and faint, or agitated and racing. The tongue is pale.
Yang desertion: yang collapse
Desertion pattern: any kind of desertion, such as yin desertion or yang desertion
PRACTICE

1 Breathe
2 Congest
3 Contract
4 Debilitate
5 Desert
6 Distend
7 Effuse
8 Expectorate
9 Identify
10 Void
1. Exterior cold patterns are characterized by ___________ cold signs with a distinct
aversion to cold.
A. pronouncing B. pronounced C. pronunciation D. pronounce
2. ___________ patterns are characterized by pronounced heat signs, such as a red

sore pharynx and a relatively red tongue with dry fur.
A. Exterior heat B. Exterior cold C. Interior heat D. Interior cold
3. Heat effusion (___________) is a sign which does not necessarily correspond to heat
in the sense of the eight principles.
A. cold B. temperature C. fever D. shiver
4. Mid-stage pattern (half-interior half-exterior pattern) is a disease pattern that occurs

when an exterior evil fails to reach the interior and ___________ is too weak to fight it.
A. yin B. yang C. evil qi D. right qi
95
5. Heat patterns arise when a ___________ invades the body or when ___________
becomes insufficient.
A. yang evil / right qi B. yang evil / yin humor
C. yin humor / evil qi D. yin humor / yang evil
6. ___________ is any disease pattern caused by weakness of the body‘s forces and
absence of an evil.
A. Vacuity pattern B. Desertion pattern
C. Yin vacuity D. Yang vacuity
7. ___________ is the manifestation of insufficiency of yang qi; reduction in the

warming and activating power of the body.
A. Vacuity pattern B. Desertion pattern
C. Yin vacuity D. Yang vacuity
8. Heat patterns are caused by a surfeit of yang or a deficit of yin, ___________

repletion heat or vacuity heat patterns, respectively.
A. that form B. which form C. formed D. which forming
9. ___________, external evils may strike the interior directly; in most cases, they pass
through the exterior.
A. Generally speaking B. Commonly C. In general D. Rarely
10. Exterior vacuity ___________ construction-defense disharmony in which the body‘s

resistance to external evils is lowered and, despite sweating, fails to expel the evil.
A. leads to B. results in C. results from D. causes
1. Runny nose with clear snivel (nasal mucus) and expectoration of clear thin phlegm is
A B C
common signs. Exterior cold patterns are caused by contraction of wind-cold evil.
D
2. Most exteriorly heat patterns are attributable to contraction of wind-heat evil.

A B C D
3. Heat effusion (fever) is a sign which not necessarily correspond to heat in the sense
A B C D
of the eight principles.
4. Interior pattern is any disease pattern indicated disease of the interior.

A B C D
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5. Heat pattern is some disease pattern characterized by heat signs.
A B C D
6. Vacuity taxation is any pattern of severe vacuity (of qi, blood, bowels, or viscera),
A B
including notable steaming bone and consumption.
C D
7. Yin vacuity is the manifestation of insufficiency of the yin aspect and depletion of
A B C
liquid and bloody.
D
8. Yin vacuity may be focused in any out of the five viscera, especially in the kidney.
A B C D
9. Yang vacuity is treated by warming yang and boosted qi.

A B C D
10. Distinction is made among exterior cold, exterior heat, exterior vacuity, and exterior
A B C D
repletion.
sentences.
1. Exterior pattern is the manifestation of disease in the exterior of the body, caused by
any of the six excesses entering the body‘s exterior; characterized by sudden onset and
by aversion to cold (or the milder aversion to wind), heat effusion (fever), headache, a
thin tongue fur, and a ___________ pulse. (float)
2. ___________ pattern is any condition in which the presence of an evil is resisted by

the body; the opposite of vacuity pattern. (replete)
3. Repletion heat patterns are characterized by red complexion, red eyes, vigorous heat
(effusion), agitation, ___________, desire for cold fluids, hard stool, short voidings of
reddish urine, a red or crimson tongue with a yellow fur, and a rapid pulse or a rapid
large surging pulse. (thirsty)
4. In yin collapse, the chief signs are copious sweat, ___________ hot skin, and warm
limbs or reversal cold of the limbs with heat in the hearts of the soles and palms.
(palpation)
5. Most importantly, however, there are signs of right qi fighting the evil, such as pulses
that are forceful at the deep level (e.g., rapid surging pulses, slippery stringlike pulses,
97
and large replete pulses), pain or ___________ that refuses pressure, and sudden
onset of disease. (comfortable)
6. Since these ___________ frequently affect specific bowels or viscera, further

distinction is made between such forms as heart yin vacuity liver blood vacuity, kidney
yang vacuity, lung qi vacuity, etc. (sufficient)
7. Yin and yang, which embrace the other six principles, are general ___________ of
disease. (categorize)
8. ___________, cold, and vacuity are yin, whereas exterior, heat and repletion are
yang. (Inferiority)
9. In exterior cold, the pulse is tight and floating, the tongue fur is thin, white and
___________. (moisture)
10. Prevalence of yin due to an ___________ yin evil accounts for pronounced cold
signs such as abdominal pain, fulminant (i.e., sudden and violent) vomiting or diarrhea,
green-blue facial complexion, and a tight pulse. (exuberant)
Disease Patterns
addition confirmed important critical cause
refer determining procedures practitioners combination
(1) __________ of modern Traditional Chinese Medicine hold that "Patterns"

("Zhèng") within the functional entities within the human body are (2) __________ to
determining the (3) __________ of disease. Such Patterns are commonly referred to
as "Patterns of Disharmony" or "Functional Disturbances" of disharmony by and among
Qi, Xuě, Body fluids, Zàng-fǔ, and the Meridians which are (4) __________ by their
symptoms and "signs", such as pulse and tongue related diagnostic (5) __________ .
In (6) __________ to the foregoing, the identified pattern of disharmony typically

involves a (7) __________ of affected entities where the Pattern identified supports
symptomology.
The process of (8) __________ which actual pattern is on hand is usually translated
as "pattern diagnosis", "pattern identification" or "pattern discrimination". Generally, the
first and most (9) __________ step in pattern diagnosis is an evaluation of the
present signs and symptoms on the basis of the "Eight Principles". These eight
principles (10) __________ to four pairs of fundamental qualities of a disease:
exterior/interior, heat/cold, vacuity/repletion, and yin/yang.
98
Exterior refers to a disease manifesting in the superficial layers of the body – skin, hair,
flesh, and meridians. It is characterized by aversion to cold and/or wind, headache,
muscle ache, mild fever, a "floating" pulse, and a normal tongue appearance.
Interior refers to disease manifestation in the zàng-fǔ, or (in a wider sense) to any
disease that cannot be counted as exterior. There are no generalized characteristic
symptoms of interior patterns, since they'll be determined by the affected zàng or fǔ
entity.
Cold is generally characterized by aversion to cold, absence of thirst, and a white

tongue fur. More detailed characterization depends on whether cold is coupled with
vacuity or repletion.
Heat is characterized by absence of aversion to cold, a red and painful throat, a dry
tongue fur and a rapid and floating pulse, if it falls together with an exterior pattern. In all
other cases, symptoms depend on whether heat is coupled with vacuity or repletion.
Vacuity, often referred to as "deficiency", can be further differentiated into vacuity of qi,
xuě, yin and yang, with all their respective characteristic symptoms. Yin vacuity can also
be termed "vacuity-heat", while yang vacuity is equivalent to "vacuity-cold".
Repletion often called "excess", generally refers to any disease that can't be identified
as a vacuity pattern, and usually indicates the presence of one of the Six Excesses, or a
pattern of stagnation of qi or xuě. In a concurrent exterior pattern, repletion is
characterized by the absence of sweating. The signs and symptoms of repletion-cold
patterns are equivalent to cold excess patterns, and repletion-heat is similar to heat
excess patterns.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
99
Overview of Traditional Medicine
Traditional medicine refers to the knowledge, skills and practices based on the theories,
beliefs and experiences indigenous to different cultures, used in the maintenance of
health and in the prevention, diagnosis, improvement or treatment of physical and
mental illness.
Traditional medicine is often termed alternative or complementary medicine in many

countries. Herbal treatments are the most popular form of traditional medicine and 70%
to 80% of the Region has used a form as primary health care.
One third of the population lacks access to essential medicines and the provision of
safe and effective traditional and alternative remedies could become an important way
of increasing access to health care services.
Tried and tested methods and products:
 Acupuncture has been proven effective in relieving a variety of pain disorders,

high blood pressure, depression and morning sickness. It can also alleviate
postoperative pain and adverse reactions to chemotherapy.
 The Chinese herb Artemisia annua has been found to be effective against
resistant malaria and could create a breakthrough in preventing almost 1 million
deaths annually.
 In South Africa, the plant Sutherlandia microphylla is being studied for use in HIV
patients. The plant may increase energy, appetite and body mass in people living
with HIV.
Questions
1. What does traditional medicine refer to?

______________________________________________________________________
______________________________________________________________________
2. What is traditional medicine used for?

______________________________________________________________________
______________________________________________________________________
3. What is considered the most common form of traditional medicine?

______________________________________________________________________
______________________________________________________________________
100
4. What could become a major way of increasing access to health care services?
______________________________________________________________________
______________________________________________________________________
5. What is supposed to be effective against resistant malaria and be able to create a
breakthrough in preventing almost 1 million deaths every year?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
101
UNIT
DIAGNOSIS AND THE

8 PATHOLOGICAL MODEL
DIAGNOSIS
A. Auscultation and Olfaction
Auscultation (listening) and olfaction (smelling) are two methods used to diagnose a
disease.
Listening to the Voice
Speaking Voice: Generally, speaking in a loud and sonorous voice indicates syndromes
of heat or shi type, while a feeble, low voice indicates syndromes of the cold or xu type.
Disordered Speaking: Speaking incoherently and loudly or deliriously indicates shi
syndrome. Speaking verbosely, feebly, and intermittently indicates syndromes of the xu
type. Muttering to oneself denotes qi deficiency of the heart. Stuttering speech suggests
upward disturbance of wind-phlegm.
Listening to the Respiration
Feeble Breathing: Feeble breathing accompanied by shortness of breath usually
indicates xu syndromes.
Coarse Breathing: Forceful breathing with a coarse voice belongs to the shi heat type
syndromes. Asthma with feeble, short breathing is a category of xu type asthma.
Listening to the Cough
Course coughing usually indicates shi type syndromes. A low cough with weak
breathing indicates xu syndromes.
Smelling
Foul breath is due to pathogenic heat in the stomach, indigestion, caries, and an
unclean mouth. Sour breath indicates food accumulation in the stomach.
The offensive smell of a secretion or excretion including stool, urine, sputum, pus,
leukorrhea, etc., usually indicates heat syndromes of the shi type. A stinking smell
usually indicates cold syndromes of the xu type.
B. PALPATION
Palpation is a method of diagnosis using the hand to touch, feel, and press certain
areas of the body to ascertain the patient's disease condition. Generally there are two
types: Pulse Feeling and Body Palpation.
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I. Hand/Wrist Pulse Feeling
In traditional Chinese medicine the pulse is considered as having three divisions: cun,
guan, and chi. A normal pulse is neither superficial nor deep, neither quick no slow, and
it beats in medium frequency, i.e., 4-5 beats per breath, with a regular rhythm.
To feel the pulse correctly, place the patients hand comfortably on a cushion with the
palm facing upward. First, the practitioner should put their middle finger on the guan
division, then the index and ring fingers should naturally fall on the cun and chi
divisions. Finger force should at first be light, then moderate and finally heavy to get a
general picture of the depth, rhythm, strength, and form of the pulse. An even force
should be applied on the three regions. Through comparisons of the three regions, the
practitioner can gain a correct impression of the pulse as a whole. A normal pulse is of
moderate frequency, i.e., 4-5 beats per breath, regular rhythm, even and forceful.
The following are abnormal pulses commonly seen in the clinic:
Floating Pulse (fumai): When the pulse is pressed lightly, it appears under the finger,
and when pressed heavily it becomes weak. It often occurs in the early stages of
diseases caused by exogenous pathogenic wind cold and heat, i.e., exterior syndromes.
If it is seen in patients who are suffering from prolonged chronic diseases, it indicates a
dangerous site where the yang qi of the body flows outward.
Deep Pulse (chimai): No clear pulse is felt by superficial pressure, only by heavy
pressure. This indicates an interior syndrome.
Rapid Pulse (sumai): The pulse beats rapidly at a rate higher than the normal 5 beats
per breath (i.e., more than 90 times per minute). This indicates a heat syndrome.
Xu Type Pulse (xumai): If the pulses of the three regions are weak and forceless, this
indicates xu type syndromes. These are mostly caused by both qi and blood
deficiencies and are seen during the process of chronic diseases.
Shi Type Pulse (shimai): If the pulses of the three regions are forceful with both light
and heavy pressure, shi type syndromes are present.
Slippery pulse (huamai): If the pulse is smooth and flowing, like a pearl rolling on a
plate, this indicates excessive phlegm, retention of food, or shi heat type syndromes.
Rough Pulse (semai): This pulse is uneven and has a roughness similar to scraping
bamboo with a knife. It indicates a deficiency of blood and essence, qi stagnation, and
blood stasis.
Fine Pulse (ximai): This pulse is as fine as a silk thread, and indicates exhaustion of qi
and blood.
Full Pulse (hongmai): This pulse beats like a dashing wave, with one rising wave
following another. It indicates excessive heat.
Wiry Pulse (xuanmai): This pulse is straight and long, like a tremulous music string,
seen usually in diseases of liver, gall bladder, pain, or phlegm-humor.
Tense Pulse (jinmai): The pulse is taut and forceful, like a tightly stretched cord, and
occurs in diseases caused by cold, pain, or retention of food.
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Hollow Pulse (koumai): This pulse is floating, large, and empty inside, feeling like a
scallion stalk. It indicates a massive loss of blood and essence.
Hesitant Pulse (cumai)
This pulse is rapid with irregular intermittent beats. It indicates excessive yang and shi
heat, qi stagnation, pathogenic phlegm mixture with cold, blood stasis, etc.
Knotted Pulse (jiemai): This pulse is slow and uneven with irregular intervals. It
indicates excessive yin, qi stagnation, pathogenic phlegm mixture with cold, blood
stasis, etc.
Intermittent Pulse (daimai): This pulse is slow with regular intervals. It indicates qi
exhaustion of the zang organs, or syndromes of wind and pain caused by emotional
pathogenic fright and fear.
II. Body Palpation
This is a diagnostic method to ascertain abnormal changes in the body and to
determine the location and nature of the disease through palpation and finger pressure.
Palpating the Skin and Muscle
Generally, if there is excessive pathogenic heat in the body, the patient will usually have
heat on the body surface. Yang qi deficiency has a cold body surface on palpation. If
the surface feels hot on first palpation becoming slightly hotter when you palpate longer,
this indicates that the pathogenic heat has proceeded from the exterior to the interior of
the body. Body palpation showing moist and smooth skin demonstrates that the body
fluid is not yet damaged. If the skin and nails are very dry, this indicates consumption of
the body fluids. If body palpation shows swelling and further pressure makes a
depression, this indicates edema. If a depression appears on pressure and disappears
after taking the hand away, this indicates qi distension. Palpating the skin can also
indicate the patient's sweat condition.
Palpating Hands and Feet
Coldness of the four extremities is mostly due to yang deficiency and excessive
pathogenic cold. An overheating of the four extremities indicates excessive heat.
Coldness of the four extremities with heat in the chest and abdomen is due to the
retention of internal heat preventing the flow of yang qi outward. Heat in the dorsum of
the hand is a sign of disease caused by exogenous pathogenic factors.
Palpating the Epigastrium and Abdomen
If the patient has fullness and distention of the hypochondrium, palpation may
demonstrate hardness and pain in this region. This is known as an accumulation of
excessive pathogenic factors in the chest of the xu type. If the hardness extends over a
large area in the chest, it is due to phlegm-humor.
Palpation of the abdomen showing abdominal distention with a tympanitic note on
percussion, but with normal urination, indicates qi tympanites. Abdominal distension
with a splashing sound like water, and accompanying dysuria indicates was tympanites
or ascites. If hand pressure relieves the abdominal pain, it is considered to be a xu type;
if the pain is made worse by pressure, it is a shi type. Immovable hard masses in the
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abdomen with pain fixed in a certain area are due to blood stasis. However, if the
patient feels that lumps sometimes appear and disappear with unfixed pain, and
palpation of the abdomen shows they do not exist, then this is due to qi stagnation.
Palpating Channels and Points
Clinical practice proves that in some diseases there may occur tenderness or abnormal
reactions along the courses of the affected channels or at certain points. These signs
have significance in diagnosis by palpation, especially in acupuncture treatment. For
example, there may be tenderness at Pt. Zhongfu or Pt. Shufu, which are closely
related to the disorders of the lung and trachea. In diseases of the heart and stomach,
tenderness may occur at Pt. Jugue of Ren, Pt. Zhongwan of Ren, Pt. Burong, or Pt.
Liangmen. In disorders of the liver and gall bladder, tenderness may be at Pt. Qimen
and Pt. Riye. In diseases of the spleen, tenderness may occur at Pt. Zhangmen and Pt.
Huangmen. In disorders of the kidney, Pt. Jingmen and Pt. Zhishi may have tenderness.
Tenderness at Pt. Tianshu. Pt. Daji and Pt. Fujie may be closely related to disorders of
the intestines. Tenderness at Pt. Guanyan, Pt. Qihai and Pt. Zhongji may have a close
relation with disorders of the urinogenital system. When there are abnormal reactions
appearing at the above points, they may reflect pathological changes of the related
zang or fu organs.
C. INSPECTION
Inspection is a method to examine the patient by observation of the expression,
appearance, color, and abnormal changes of secretion and excretion, etc.
I. Observation of the Mind
This is to observe the patient's spirit, clearness of consciousness, coordination and
vigour of movements, and keenness of response in order to judge the excess or
deficiency of yin, yang, qi, and blood in the zang-fu organs and make a prognosis of the
disease condition.
Strength of Spirit: The patient is in good spirits, the body resistance and functions of
the zang-fu organs are normal, therefore the patient has a good prognosis. Generally
speaking, the patient is in good spirits, behaves normally with a sparkle in the eye, and
has a keen response.
Loss of Spirit: The patient is spiritless, indifferent in expression, has dull eyes and a
sluggish response, or may even be unconscious or have a mental disturbance. This
shows damage to the body resistance, a severe disease condition, and a poor
prognosis.
II. Observation of the Complexion
Observe the color and luster of the facial region. Generally, a lustrous complexion with
normal color indicates ample qi and blood, and a mild disease with a good prognosis. If
the complexion is deep in color and withered, this indicates a serious disease condition
with damage to the qi and essence, and a difficult treatment with poor prognosis.
White Color: A white color is the sign of a qi and blood deficiency. A pale complexion
indicates a yin excess with yang deficiency. A qi deficiency manifests a lusterless and
pale complexion and is accompanied by swelling. A pale emaciated face indicates a
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blood deficiency. A sudden pale complexion with cold sweat is the sign of sudden
prostration of yang qi due to febrile diseases caused by exogenous pathogenic wind-
cold.
Yellowish Color: a yellowish color is the sign of spleen deficiency and damp
accumulation. A complexion that is yellowish, withered and lusterless indicates a qi
deficiency of the spleen and stomach. A yellowish, flabby complexion is the sign of
damp accumulation due to spleen dysfunction of transportation and transformation. The
yellow color of the face, eyes, and skin indicates jaundice. In traditional Chinese
medicine a bright orange yellow is diagnosed as yang jaundice caused by pathogenic
damp-heat; dark yellow in yin jaundice due to pathogenic cold-damp.
Red Color: Redness indicates excessively full blood vessels due to excessive heat. A
red complexion is mostly due to the fever of a common cold, or may be a heat
syndrome due to excessive yang in the zang-fu organs. Malar flush with bright red color
indicates xu heat syndromes due to yin deficiency and yang preponderance.
Bluish Color: Bluish color indicates syndromes of cold, pain, and blood stasis or
convulsion, and is the manifestation of qi and blood obstruction in the channels.
Pathogenic cold causes stagnation of qi and blood leading to pain. Children's high fever
also shows a bluish complexion, the symptoms of acute convulsion.
Black Color: Black color indicates kidney deficiency, humor accumulation, and blood
stasis. This is the manifestation of excessive cold and water, or stagnation of qi and
blood. If the complexion is as black as bronze, it is mostly due to an extreme weakness
of kidney yang and cold accumulation manifesting as xu-cold syndromes. A dark dray
color around the eyes denotes phlegm-humor syndrome due to kidney deficiency. This
leads to a dysfunction of the water metabolism or leukorrhea, due to the downward
flowing of kidney essence. A dark gray malar can be seen in patients with frequent
urination due to kidney deficiency. A dark gray complexion indicates prolonged
stagnation of blood such as a consumptive disease with blood deficiency accompanied
by menoplania or amenia.
III. Observation of the Tongue
Tongue Proper
Pale Tongue: Indicates xu and cold syndromes or symptoms due to yang qi deficiency
and insufficiency of qi and blood.
Red Tongue: Indicates heat syndromes, mostly shi types of disease caused by interior
heat, or symptoms of fire preponderance due to yin deficiency.
Deep Red Tongue: Denotes the excessive heat seen in febrile disease due to invasion
of exogenous pathogenic heat which as been transmitted from the exterior to the interior
of the body. It also can be seen in miscellaneous diseases due to a preponderance of
fire caused by yin deficiency, or seen in diseases of accumulated fire in the liver
channel.
Purplish Tongue: Shows the syndrome of blood stagnation. A tongue with purplish
spots or petechiae also indicates blood stagnation.
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Tongue Appearance
Flabby Tongue: A flabby tongue body with teeth marks on the margin and pale in color
indicates a yang deficiency of the spleen and kidney leading to accumulation and
obstruction of phlegm-dampness. A flabby tongue with a deep red color indicates
excessive pathogenic heat attacking the heart and spleen.
Thin and Small Tongue: This indicates consumption and deficiency of blood and yin. A
thin and small tongue with a pale color denotes deficiency of both qi and blood. A thin
dry tongue with a deep red color is mainly due to a preponderance of fire and great
exhaustion of body fluids.
Rigid Tongue: Seen in febrile diseases due to the invasion of exogenous pathogenic
heat transmitted into the pericardium or due to an obstruction of pathogenic phlegm. It
may also be seen in high fever leading to consumption of body fluids and
preponderance of pathogenic heat. It is a prodrome of wind-stroke (cerebral stroke).
Deviated Tongue: This is a prodrome of wind-stroke.
Cracked Tongue: Cracks on the tongue with deep red color indicate excessive heat. A
cracked pale tongue indicates insufficiency of yin and blood. However, a cracked
tongueof long term duration without any other symptoms can be considered normal.
Tongue Coating
In the first place, the properties of tongue coating should be examined.
Thinness and Thickness: Generally, if substantial pathogenic factors such as damp,
phlegm or food accumulation occur and cause obstruction, they further affect the spleen
and stomach leading to the ascent of turbid qi and forming of a thick tongue coating. A
white thin tongue coating is formed if nonsubstantial pathogenic factors such as wind,
heat, dryness, or cold attack the body; or if the pathogenic factors stay on the body
surface; or if body resistance is weak during the disease development.
Moistness and Dryness: The normal tongue coating is moist, which indicates that
plenty of body fluid is flowing upward. If the tongue coating is dry, it is due to body fluids
failing to moisten the tongue. A dry tongue coating may also be present in some febrile
diseases where pathogenic heat consumes the body fluid. A slippery tongue coating
may be due to pathogenic damp-humor floating over the tongue surface.
Sticky and Curdled Tongue Coating: A sticky coating is due to hyperactivity of
endogenous pathogenic phlegm and damp rising to the tongue, and is mostly seen in
diseases caused by pathogenic damp-heat or phlegm-humor. A curdled tongue coating
is the outcome of food accumulation in the stomach leading to the ascent of turbid qi to
the tongue surface. It is also seen in disease caused by phlegm-damp.
Peeled Tongue Coating: Mostly due to deficiency of qi and yin. If peeled tongue is
accompanied by a sticky coating, it indicates a complicated disease condition to which
the body resistance is weakened.
No Tongue Coating: Changes in the tongue coating indicate fluctuation in the disease
condition. For example, if a qi deficiency of the stomach is manifested by no tongue
coating at an early stage, the tongue coating will reappear after the stomach qi is
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recovered. If a disease has no tongue coating, then suddenly appears, this indicates a
perversive flow of stomach qi, or excessive pathogenic heat. If a disease has a tongue
coating at the beginning which disappears abruptly, this indicates stomach yin fluid has
decreased. If a thick coating gradually turns into a thin white coating, this indicates that
pathogenic qi is being gradually weakened, and the disease condition is becoming
milder.
Generally, an observation of the thinness and thickness of the tongue coating will
indicate the depth of pathogenic qi. The tongue's moistness or dryness shows the body
fluid condition. The degree of curdling and stickiness of the tongue coating indicates the
dampness of the stomach and spleen. The appearance or disappearance of tongue
coating signified the cure or worsening of the disease condition.
Color of Tongue Coating
White Coating: Indicates exterior-cold syndromes. A white and thin coating is seen
mostly in exterior syndromes, while a white and thick coating appears in interior-cold
syndromes. If there is a powder-like whitish coating covering the tongue surface, it is
caused by the internal accumulation of summer-humid heat and is usually seen at the
onset of pestilential diseases.
Yellow Coating: Indicates interior and heat syndromes. A light yellow tongue coating is
seen in cases of slight fever. A deep yellow color indicates high fever. Brownish tongue
coatings represent an accumulation of pathogenic heat.
Grayish Coating: Denotes interior-heat syndrome or interior-cold syndrome. A grayish
black and slippery coating on the tongue usually indicates symptom-complex due to
cold-damp in the interior. A grayish, yellow, and sticky tongue coating usually indicates
the accumulation of damp-heat. Grayish and dry tongue coatings are usually due to the
consumption of body fluid by excessive heat.
Black Coating: This is often seen at the serious and dangerous stage of disease, and
indicates extreme heat or cold. A black, yellow, and dry coating with thorns on the
tongue surface usually denotes consumption of body fluid by extreme heat. A black and
slippery tongue coating shows excessive cold due to yang deficiency.
THE PATHOLOGICAL MODEL
A. THE PATHOLOGICAL MODEL OF HEAT ILLNESS
I. THE PATHOLOGICAL MODEL: INCREASED FIRE
INCREASED FIRE stimulates EARTH and stimulates WOOD and inhibits METAL
and WATER.
1. Symptoms of the Increased Thermal Function or FIRE increased
 Heat Sensation
 Redness
 Fever
 Inflammation
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 Infection
 Pain
 Bleeding
 Thirst
 Fast pulse > 90/min
2. Symptoms of the Increased Secretory function or EARTH Increased
 Heavy sweating
 Yellow urine
 Diarrhea with mucus
 Thick, bad-smelling, yellow Leucorrhoea
 Yellow eye discharge
3. Symptoms of the Decreased Absorbing Function or METAL Decreased
 Decreased respiratory Absorption: thoracic oppression, superficial breathing,.

 Reduced gastrointestinal absorption: diarrhea
 Reduced renal Absorption: pollakiuria, nocturia
4. Symptoms of the Decreased Accumulation function or WATER Decreased
 Sensation of cold
 Weight loss
5. Symptoms of the Increased Motor Function or WOOD Increased
 Hyperactivity
 Contractures, cramps, spasms
 Increased peristalsis
 Increased Toning
 Muscle hypertrophy
 Spasticity
 Pulse: strong
II. THE DISEASES OF INCREASED FIRE
1. The Diseases of the Respiratory System
 Rhinitis
 Bronchitis
 Pneumonia
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 Hot asthma
 Tuberculosis
 Angina
 Tonsillitis
 Pharyngitis
 Allergy
2. Diseases of the central nervous and circulatory system
 Active neurasthenia/ Depression

 Insomnia
 Neuralgia
 Drug addiction
3. Diseases of the digestive tract
 Dysentery
 Colitis
 Hepatitis
 Pancreatitis
 Constipation
 Ulcer
 Inflammamtions, infections of the digestive tract
4. Diseases of the Musculo Skeletal System
 Articular rheumatism: arthritis

 Polyarthritis
 Fibromyalgia
 Pain: lower back, neck
5. Diseases of the Uro – Genital system
 Nephritis, pyelonephritis
 Urinary infections
 Metrorrhagia
 Metritis
 Bleeding
III. FUNCTIONAL EVALUATION: EXCESS OR DEFICIENCY OF YIN-YANG
3 possible causes are the origin of the increased thermal function.
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1. YANG increased that Stimulates the Function
Good general condition
Acute illness
Superficial Pulse
This is a state of EXCESS.
2. YIN decreased which does not inhibit the function therefore it increases
Bad general condition
Chronic disease
Deep pulse
This is a state of DEFICIENCY.
3. YIN YANG increased and decreased simultaneously
This is a state of EXCESS and a state of DEFICIENCY simultaneously.
IV. THE METHOD OF TREATMENT OF INCREASED FIRE
In front of any disease of the case Increased FIRE, we must diagnose the disturbed
Meridians and treat with the corresponding FIRE points:
Lu Ht Pe LI Si TB Sp K Liv St Bl GB
10 8 8 5 5 6 2 2 2 41 60 38
Then either:
1. YANG FIRE INCREASED:
We must DISPERSE YANG FIRE by:
Acupuncture of the YANG FIRE POINTS on the disturbed meridians
Pharmacopoeia with plants that disperse YANG FIRE
2. YIN FIRE DECREASED
We must TONIFY YIN FIRE by:
Acupuncture of the YIN FIRE POINTS on the disturbed meridians
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Pharmacopoeia with plants that tone up YIN FIRE
We must TONIFY deficient ROOTS.
3. YANG FIRE INCREASED and YIN FIRE DECREASED
We must DISPERSE YANG FIRE and TONIFY YIN FIRE at the same time.
B. THE PATHOLIGCAL MODEL OF COLD DISEASES
THE PATHOLOGICAL MODEL “WATER DECREASED”
I. WATER DECREASED does not stimulate WOOD and METAL it does not inhibit
FIRE and EARTH.
1. Symptoms of the Decreased Accumulation Function or WATER Decreased
 Weight loss
 Sensation of cold
 Dark color of skin
 Sexual weakness
 Pulse: slow < 60/mm
2. Symptoms of the Decreased Motor Function or WOOD Decreased
 Passivity
 Muscle weakness
 Diminished tone
 Paralysis
 Muscle fatigue
 Low blood pressure
 Weak pulse
3. Symptoms of the Increased Thermal Function or FIRE Increased
 Heat sensation in the upper body

 Red tip of the tongue
 Light fever
 Light inflammation
 Light pain
4. Symptoms of the Increased Secretory Function or EARTH Increased
 Abundant secretions: urines, stools, sweat, Saliva, tears

 Clear diarrhea
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 Clear leucorhea
 Spermatorrhoea
5. Symptoms of the Decreased absorbing Function or METAL Decreased
 Decreased respiratory absorption:
- Superficial breathing, dyspnea
- Chest tightness, thoracic Oppression
 Reduced gastrointestinal absorption
- Diarrhea, watery liquid stools
- Bloating, gas
 Reduced kidney Absorption
- Polyuria
- Important Nocturia
II. DISEASES OF WATER DECREASED
1. The diseases of the respiratory system
Rhinitis
Bronchitis
Pneumonia – broncho-pneumonia
Cold asthma
White angina, tonsillitis
Allergy
2. Diseases of the Digestive System
Diarrhea
Constipation
Colitis
Diseases of the Stomach: gastritis, ulcer...
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3. Diseases of the Central Nervous and Circulatory System
Passive Neurasthenia, passive Depression
Neuralgia
Insomnia
Neuro-vegetative Disorders
Psycho-somatic Decline
4. Diseases of the Articulo-Muscular System
Joint rheumatism
Myalgia
Arthrosis
5. Diseases of the Uro-Genital System
Nephritis
Pyelonephritis
Urinary infection
White leucorrhoea
Spermatorrhoea
Weakness of the uterine contractions
Low blood pressure
Anemia
Psycho-somatic decline
III. FUNCTIONAL EVALUATION: EXCESS or DEFICIENCY of YIN-YANG
3 possible causes are the origin of the Decreased Accumulation Function:
1. YANG decreased which does not stimulate teh Function
 Bad general condition

 Chronic disease
 Internal disease
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 Deep pulse
This is a state of DEFICIENCY.
2. YIN increased which inhibits the function
 Good general condition

 Acute illness
 External disease
 Superficial pulse
This is a state of EXCESS.
3. YANG Decreased and YIN Increased Simultaneously.
This is a state of DEFICIENCY and EXCESS Simultaneously.
IV. THE METHOD OF TREATMENT OF WATER DECREASED
In front of any disease of the case WATER decreased, we must first diagnose the
disturbed Meridians and treat the corresponding WATER points:
Lu Ht Pe LI Si TB Sp K Liv St Bl GB
5 3 3 2 2 2 9 10 8 44 66 43
Then, depending on the case:
1. YANG WATER DECREASED
We must TONIFY YANG WATER by:
Acupuncture of the Points YANG WATER on disturbed Meridians
Moxibustion of the Points YANG WATER on disturbed Meridians
Pharmacopoeia with plants that tones up YANG WATER.
We must TONIFY the Deficient ROOTS.
2. YIN WATER INCREASED
We must DISPERSE YIN WATER by:
Acupuncture of the Points YIN WATER on disturbed Meridians
Mosibustion of the Points YIN WATER on disturbed Meridians
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3. YANG WATER Decreased and YIN WATER Increased
We must TONIFY YANG WATER and DISPERSE YIN WATER at the same time.
C. SOME CLINICAL CASES
CASE 1
Mrs. H, 34 years old, Teacher
Consultation for shoulder pain for 3 years
Symptoms: frequent fatigue, irradiating pain in the arm, aggravated by movement and
change of temperature (heat). Sweating, palpitation, poor appetite, loss of weight
Pulse is fast, deep, SHUO-XI-CHEN
Tongue is narrow, red, dry.
4 QUESTIONS:
1 – 6 Roots:
JING: chronic disease (3 years)
QI: fatigue
XUE Stagnation: pain aggravated by Movement
2 – 12 Branches: sensitive channels
Gb, Si, TB, Li, Ht
3 – 5 Leaves:
Wood: Palpitation: Wood Up
Fire: Pain, aggravated by heat: Fire Up
Earth: Sweating: Earth Up
Metal: poor appetite: Metal down
Water: loss of weight: Water down
The Main Cause is FIRE INCREASED.
4 – Excess/ Deficiency of YIN/YANG
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Chronical Disease: deficiency
Deep Pulse: Deficiency
Bad General State: Deficiency
FIRE INCREASED: YIN FIRE Deficiency
FUNCTIONAL EVALUATION:
JING Deficiency – QI Deficiency – XUE Stagnation – YIN FIRE Deficiency
Treatment:
Tone up JING: K3 – RM 4
Tone up AI: RM 6
Activate XUE: GB 21 – LI 10
Tone up YIN FIRE: GB 38 – Si 5 – TB 6 – LI 5 – Ht 8
CASE 2
Mr. BT, 35 years old , clerk
Consultation for headache for one week
Symptoms: pulsatile pain, insomnia.
Sweating, poor appetite, loss of weight
Pulse is fast, superficial, broa; SHUO-DA-FU
Tongue is red (scarlet) and moist, bright.
4 QUESTIONS:
1 – 6 Roots:
JING: ok
QI: ok
QI: ok
XUE: ok
SHEN: ok
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JIN YE: ok
2 – 12 Branches: sensitive channels
TB, Li, Sp, Bl
3 – 5 Leaves:
Wood: Pulsatile pain: Wood Up
Fire: Pain: headache: Fire Up
Earth: Sweating: Earth Up
Metal: poor appetite: Metal down
Water: loss of weight: Water down
The Main Cause is FIRE INCREASED.
4 – Excess/ Deficiency of YIN/YANG
Acute Disease: Excess
Superficial Pulse: Excess
Good General State: Excess
FIRE INCREASED: Excess of YANG FIRE
FUNCTIONAL EVALUATION:
Excess of YANG FIRE
Treatment:
Disperse YANG FIRE: GE 38 – LI 5 – Sp 2 – Bl 60
PRACTICE

1 Appear
2 Compare
3 Diagnose
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4 Exhaust
5 Impress
6 Indicate
7 Inspect
8 Percuss
9 Prevent
10 Secrete
1. ___________ (listening) and ___________ (smelling) are two methods used to

diagnose a disease.
A. Auscultation/ olfaction B. Percussion / auscultation
C. Olfaction / percussion D. Palpation / olfaction
2. ___________ breathing with a ___________ voice belongs to the shi heat type
syndromes.
A. Labored/ coarse B. Soft / sonorous
C. Forceful / coarse D. Labored / sonorous
3. ___________ is a method of diagnosis using the hand to touch, feel, and press
certain areas of the body to ascertain the patient's disease condition.
A. Percussion B. Palpation C. Olfaction D. Inspection
4. To feel the ___________ correctly, place the patients hand comfortably on a cushion
with the palm facing upward.
A. heartbeat B. vibration C. heart sound D. pulse
5. A normal pulse is of moderate ___________, i.e., 4-5 beats per breath, regular
rhythm, even and forceful.
A. intensity B. strength C. frequency D. vibration
6. Body palpation showing moist and smooth skin demonstrates ___________ the body
fluid is not yet damaged.
A. that B. which C. in which D. of which
7. Palpating the skin can also indicate the patient's ___________ condition.
A. perspiration B. metabolism
C. sweat D. Both A and C
8. A complexion that is yellowish, withered and lusterless indicates a qi deficiency of the
___________.
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A. spleen and liver B. liver and kidney
C. spleen and stomach D. liver and stomach
9. Black color indicates kidney deficiency, humor accumulation, and ___________.
A. stagnation B. blood stasis C. blockage D. Both A and B
10. A white and thin coating is seen mostly in exterior syndromes, ___________ a white
and thick coating appears in interior-cold syndromes.
A. when B. while C. if D. although
1. Feeble breathing accompanied by short of breath usually indicates xu

A B C D
syndromes.
2. Foul breath is due of pathogenic heat in the stomach, indigestion, caries, and an
A B C D
unclean mouth.
3. A normal pulse is neither superficial or deep, neither quick no slow, and it beats in
A B C
medium frequency, i.e., 4-5 beats per breath, with a regular rhythm.
D
4. When the pulse is pressed lightly, they appear under the finger, and when pressed
A B C D
heavily it becomes weak.
5. Generally, if it is excessive pathogenic heat in the body, the patient will usually have
A B C
heat on the body surface.
D
6. Clinical practice proves that in some diseases there may occur tenderness or
A B C
abnormal reactions along the courses of the affecting channels or at certain points.
D
7. Inspection is a method to examine the patient by observing of the expression,

A B C
appearance, color, and abnormal changes of secretion and excretion, etc.
D
8. A yellowish color is the sign of spleen deficient and damp accumulation.
A B C D
9. Redness indicate excessively full blood vessels due to excessive heat.
A B C D
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10. Bluish color indicates syndrome of cold, pain, and blood stasis or convulsion, and
A B C
is the manifestation of qi and blood obstruction in the channels.
D
IV. Give the right form of the word in bracket to complete each of the following
sentences.
1. Generally, speaking in a loud and ___________ voice indicates syndromes of heat or

shi type, while a feeble, low voice indicates syndromes of the cold or xu type.
(sonorously)
2. The ___________ smell of a secretion or excretion including stool, urine, sputum,

pus, leukorrhea, etc., usually indicates heat syndromes of the shi type. (offend)
3. No clear pulse ___________ by superficial pressure, only by heavy pressure. This

indicates an interior syndrome. (feeling)
4. Body palpation is a ___________ method to ascertain abnormal changes in the body
and to determine the location and nature of the disease through palpation and finger
pressure. (diagnose)
5. Coldness of the four extremities is mostly due to yang deficiency and ___________
pathogenic cold. (excess)
6. Coldness of the four extremities with heat in the chest and abdomen is due to the
retention of internal heat ___________ the flow of yang qi outward. (prevent)
7. Palpation of the abdomen showing abdominal distention with a tympanitic note on

___________, but with normal urination, indicates qi tympanites. (percuss)
8. A white color is the sign of a qi and blood deficiency. A pale complexion indicates a
yin ___________ with yang deficiency. (excessive)
9. In traditional Chinese medicine a bright orange yellow ___________ as yang

jaundice caused by pathogenic damp-heat; dark yellow in yin jaundice due to
pathogenic cold-damp. (diagnosis)
10. The ___________ tongue coating is moist, which indicates that plenty of body fluid
is flowing upward. (normality)
occurs severe headache importance main
characterized factors necessary diagnosis due
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Inquiring involves asking the patient or the patient's companion about the disease
condition to assist (1) _________.
Because the chief complaint of the patient is of primary (2) _________ , the main
information dealing with the problem must be carefully solicited. It is (3) _________ to
grasp the important clinical data as well as to get a general understanding of the
patient's disease condition. Chills and Fever are among the (4) _________ categories of
concern.
Aversion to Cold and Fever: At the beginning of a disease, aversion to cold and Fever
(5) _________ simultaneously. This indicates exterior syndromes due to invasion by
exogenous pathogenic (6) _________.
The exterior syndromes (7) _________ to invasion by exogenous pathogenic cold and
wind are (8) _________ by severe aversion to cold, mild fever accompanied by an
absence of thirst, no sweat, (9) _________, general pain, superficial and tense pulse,
etc.
The exterior syndromes due to invasion by exogenous pathogenic wind-heat are

characterized by (10) _________ fever, mild aversion to cold accompanied by thirst,
sweating, sore throat, superficial and rapid pulse, etc.
Sleep
Insomnia associated with palpitation, dreams and nervousness is usually caused by the
insufficiency of blood nourishing the heart. Insomnia accompanied by restlessness in
the mind and difficulty in falling asleep indicates yin deficiency leading to preponderance
of fire. Insomnia complicated by bitter taste, vomiting saliva, palpitation, irritability, and
an inability to fall asleep indicates the internal disturbance of phlegm-fire. Insomnia due
to the disharmony of the stomach indicates a derangement of stomach qi leading to
restlessness in the mind during sleep.
Hypersomnia is commonly seen in febrile diseases caused by exogenous pathogenic

factors; in qi deficiency caused by chronic diseases; in failure of the spleen yang to
ascend due to the obstruction of damp; or in the condition of yang deficiency leading to
excessive yin.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Herbalism
Herbalism (also herbal medicine) is the study of botany and use of plants intended for
medicinal purposes. Plants have been the basis for medical treatments through much of
human history, and such traditional medicine is still widely practiced today. Modern
medicine makes use of many plant-derived compounds as the basis for evidence-based
pharmaceutical drugs. Although phytotherapy may apply modern standards of
effectiveness testing to herbs and medicines derived from natural sources, few high-
quality clinical trials and standards for purity or dosage exist. The scope of herbal
medicine is sometimes extended to include fungal and bee products, as well as
minerals, shells and certain animal parts.
The term, phytomedicine, may also refer to the science of pathology and damage to
plants, the causes thereof, their manifestations, development, dissemination, methods
for maintaining plant health, and measures used to control plant diseases and their
causes.
Herbal medicine is sometimes also used to refer to paraherbalism or phytotherapy,

which is the alternative and pseudoscientific practice of using of extracts of plant or
animal origin as supposed medicines or health-promoting agents. Phytotherapy differs
from plant-derived medicines in standard pharmacology because it does not isolate and
standardize the compounds from a given plant believed to be biologically active. It relies
on the false belief that preserving the complexity of substances from a given plant with
less processing is safer and potentially more effective, for which there is no evidence
either condition applies. Herbal dietary supplements most often fall under this category.
Questions
1. What is the definition of herbalism?
______________________________________________________________________
______________________________________________________________________
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2. What does modern medicine make use of?
______________________________________________________________________
______________________________________________________________________
3. What can be included in the use of herbal medicine?
______________________________________________________________________
______________________________________________________________________
4. What may the term phytomedicine also refer to?
______________________________________________________________________
______________________________________________________________________
5. Why does phytotherapy differ from plant-derived medicines in standard
pharmacology?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
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UNIT
ACUPUNCTURE AND
9 MOXIBUSTION
A. ACUPUNCTURE
I. What is acupuncture?
Acupuncture is a component of the health care system of China that can be traced back
at least 2,500 years. The general theory of acupuncture is based on the premise that
there are patterns of energy flow (Qi) through the body that are essential for health.
Disruptions of this flow are believed to be responsible for disease. Acupuncture may, it
has been theorized, correct imbalances of flow at identifiable points close to the skin.
The practice of acupuncture to treat identifiable pathophysiological (disease) conditions

in American medicine was rare until the visit of President Richard M. Nixon to China in
1972. Since that time, there has been an explosion of interest in the United States and
Europe in the application of the technique of acupuncture to Western medicine.
Acupuncture is a family of procedures involving stimulation of anatomical locations on or

in the skin by a variety of techniques. There are a variety of approaches to diagnosis
and treatment in American acupuncture that incorporate medical traditions from China,
Japan, Korea, and other countries. The most thoroughly studied mechanism of
stimulation of acupuncture points employs penetration of the skin by thin, solid, metallic
needles, which are manipulated manually or by electrical stimulation.
Are there standards for acupuncture needles?
After reviewing the existing body of knowledge, the U.S. Food and Drug Administration
(FDA) removed acupuncture needles from the category of "experimental medical
devices." The FDA now regulates acupuncture needles, just as it does other devices
such as surgical scalpels and hypodermic syringes, under good manufacturing practices
and single-use standards of sterility.
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What are the possible side effects of acupuncture?
The most common serious injury reported from the needles of acupuncture has been
accidental puncture of the lung, which results in a partial collapse of the lung called
pneumothorax. The most common infection reported from acupuncture treatments is
viral hepatitis, a potentially serious infection of the liver. Other side effects include
bacterial infections locally at the site of needle insertion in the skin and elsewhere in the
body. Generally, side effects seem to relate to poor hygiene and training of the
acupuncturist.
For what conditions has acupuncture treatment been found helpful?
The National Institutes of Health (NIH) Consensus Development Program was

established in 1977 and is designed to assess health technology. The program
organizes major conferences that produce consensus statements and technology
assessment statements on controversial issues in medicine important to health care
providers, patients, and the general public. The following statement is from the NIH
Consensus Development Statement on Acupuncture on November 3-5, 1997.
Acupuncture as a therapeutic intervention is widely practiced in the United States.

There have been many studies of its potential usefulness. However, many of these
studies provide equivocal results because of design, sample size, and other factors.
The issue is further complicated by inherent difficulties in the use of appropriate
controls, such as placebo and sham acupuncture groups.
However, promising results have emerged, for example, efficacy of acupuncture in adult
post-operative and chemotherapy nausea and vomiting and in post-operative dental
pain. There are other situations such as addiction, stroke rehabilitation, headache,
menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back
pain, carpal tunnel syndrome, and asthma where acupuncture may be useful as an
adjunct treatment or an acceptable alternative or be included in a comprehensive
management program.
Findings from basic research have begun to elucidate the mechanisms of action of
acupuncture, including the release of opioids and other peptides in the central nervous
system and the periphery and changes in neuroendocrine function. Although much
needs to be accomplished, the emergence of plausible mechanisms for the therapeutic
effects of acupuncture is encouraging.
The introduction of acupuncture into the choice of treatment modalities that are readily
available to the public is in its early stages. Issues of training, licensure, and
reimbursement remain to be clarified. There is sufficient evidence, however, of
acupuncture's value to expand its use into conventional medicine and to encourage
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further studies of its physiology and clinical value. This statement is representative of
the opinions of current standard medical practice.
II. SOME CASES
 Urinary Tract Infections UTI

(Am J Publ Health, 2002; 92: 1609-11). Proof Vol 7 No 4.
Women who experience repeated bouts of urinary tract infections (UTI) have a good
chance of preventing further episodes by abandoning antibiotics and using acupuncture
instead.
Norwegian acupuncture research investigated the benefits of acupuncture in 94 women,

all of whom had experienced at least three UTIs in the previous 12 months. At least two
of the infections were diagnosed and treated as a UTI by a doctor. Of the 94 women, 67
received acupuncture twice a week for four weeks.
The women with recurrent UTIs who were treated with acupuncture were half as likely
to have another bout of infection during the next six months as women who did not
receive acupuncture.
In addition, say the authors, the acupuncture-treated women showed a 50 per cent
decrease in the urine left in their bladders after urinating, while residual urine levels
remained unchanged in those not treated with acupuncture. Residual urine is a risk
factor for recurrent UTIs.
 Fibromyalgia
Sprott H et al, Rheumatol Int, 1998; 18: 35-6 Proof Vol 3, No 2.
Acupuncture may succeed where conventional medicine fails in easing the pain of
fibromyalgia, a painful muscular condition.
In a small acupuncture research study where 29 fibromyalgia patients were given

acupuncture treatment during which no analgesic medication was allowed, acupuncture
therapy was associated with decreased pain levels and fewer tender spots on the body.
Both before and after treatment, pain levels were measured using two different
methods, and a variety of bio-assays were performed.
These results seem to indicate that acupuncture produces positive chemical changes in
the body, which affect pain-modifying substances in the blood.
The authors conclude that acupuncture is an effective treatment option for the pain of
fibromyalgia.
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 Back Pain
„Acupuncture effectively relieves chronic low back pain‟
Manheimer E, White A, Berman B, et al. “Meta-analysis: acupuncture for low back
pain.” Annals of Internal Medicine. 142(8):651-663, 2005.
To assess acupuncture‘s effectiveness for treating low back pain, randomized controlled
trials were identified that compared needle acupuncture with sham acupuncture, other
sham treatments, no additional treatment, or another active treatment for patients with
low back pain.
The 33 randomized trials included in this review were grouped according to acute or
chronic pain, style of acupuncture and type of control group used. For the primary
outcome measure of short-term chronic pain relief, the meta-analysis showed that
acupuncture is significantly more effective than sham treatment and no additional
treatment. Acupuncture effectively relieves chronic low back pain. No evidence
suggests that acupuncture is more effective than other active therapies.
III. THE PURPOSE OF THE FUNCTIONAL EVALUATION:
Regardless of the patient is and the disease, the aim of the Functional Evaluation in
Traditional Oriental Medicine is primarily to answer 4 questions:
a. What is the condition of the 6 ROOTS of the Human Tree of Life?

Functional evaluation of the 6 Vital Substances.
b. What is the condition of the 12 BRANCHES?

Functional Evaluation of the 12 Functions or 12 Meridians or 6 systems.
c. What is the condition of the 6 LEAVES?

Functional Evaluation of the 6 GENERAL FUNCTIONS and the MAIN cause.
d. What is the condition of the two sides of the leaf?

Functional Evaluation of Deficiency or Excess Patterns of YIN or YANG, of chronic
or acute disease of the Causal FUNCTION.
IV. THE PURPOSE OF ACUPUNCTURE
1. Tonify the 6 ROOTS:
JING – XUE –QI –QI- SHEN –JIN YE
2. Treat the disturbed meridians
3. Regulate the 6 GENERAL FUNCTIONS:
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TONIFY in case of DEFICIENCY
DISPERSE in case of EXCESS
4. Prevent and eliminate the Causes of Diseases
V. PREPARATION of the patient BEFORE TREATMENT OF ACUPUNCTURE
1. The Positions of the patient: he must be relaxed and comfortably installed in the
positions according to the choice of the points.
2. The different needles
Acupuncture is a delicate art; we have to use very fine single use needles made of
copper and stainless steel, flexible and STERILE.
Needles will be 36 in diameter, length ½ inch (Thumb), 1 inch (Thumb), 1 ½ inch

(Thumb), 20 x 0, 15 – 25 x 0, 16.
VI. THE ART OF ACUPUNCTURE
1. The various conventional techniques:
Pressure with the finger
With the fingers of 2 hands
By stretching the skin
Japanese technique
2. Acupuncture Technique
Pull the needle backwards
Tighten the handle and remove the fingers
Quickly throw the needle
3. The good technique: to catch the ENERGY
4. The technique of TONIFICATION
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MERIDIANS
Small intestine
Large intestine
Triple burner
Spleen
Liver
Kidney
MERIDIANS
Heart
Lung
Pericardium
Stomach
Gall bladder
Bladder
5. The DISPERSION technique:
MERIDIANS
Small intestine
Large intestine
Triple burner
Spleen
Liver
Kidney
MERIDIANS
Heart
Lung
Pericardium
Stomach
Gall bladder
Bladder
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6. The effects of acupuncture
A biological effect due to the technique of tonification or dispersion.
A psychological effect due to the Art of the Acupuncturist.
7. Acupuncture and the Art to hunt points
There are various schools, various methods of Acupuncture.
All these methods have their own effects and only few side effects.
Why?
The body receives only the appropriate actions of acupuncture and remains
indifferent to others.
Acupuncture is like the art of hunting:
The practitioner can use many needles (shot gun) or a few needles or a single one
(bullet).
VII. CONCLUSION
A good technique of Acupuncture is not sufficient.
A good effect of acupuncture depends on the Art of Acupuncture.
B. MOXIBUSTION
I. Moxibustion
Moxibustion uses a common herb called Mugwort, Artemisia Chinensis (artemisia
sinensis), the Chinese form of Artemisia Vulgaris, to warm and move qi and yang
energy in the body.
The herb is ground into something a bit like grey-green cotton wool; not quite a powder
but soft and malleable, called moxa punk. It burns slowly and steadily, from one end to
the other, giving out a fairly constant heat and it does so without falling apart (if it's set
up right).
This dependability is what makes it so valuable for warming the skin and for invigorating
acupuncture points.
Where did Moxibustion come from?
Moxibustion is thought to have arisen in Northern China, where it is colder than the
South. Herbal medicine, which probably started as kitchen medicine, the kind that
housewives discovered and handed down to their daughters through the generations,
131
was then in its early stages, and mugwort might have been among herbs used or
experimented with medicinally.
To warm the body, probably they tried lots of different herbs.
Why not tobacco? Here are some suggestions:
 Tobacco was in use in South America for thousands of years before the
Americas were 're-discovered'. So the Chinese probably didn't have it when
Chinese medicine was developing.
 Perhaps because, compared with tobacco, moxa punk burns much more slowly
and steadily. Tobacco goes out unless you keep puffing at it, and its heat is less
dependable.
 When tobacco did arrive in China, it may have been much more expensive, as
well as being narcotic and, indeed, poisonous.
Anyway, although we know that opium was used for both medicinal and narcotic
purposes from the eleventh century AD we don't think the Chinese took up smoking
tobacco until the 17th century AD.
II. THE PURPOSE OF MOXIBUSTION
1. TONIFY the 6 Vital Substances by using points:
JING – TINH
XUE – MAU
QI – KHI
QI AM – KHI
SHEN – THAN
JIN YE – TAN DICH
2. TONIFY YANG Deficiency of the 6 GENERAL FUNCTIONS
YANG WATER – YANG WOOD – YANG FIRE
YANG EARTH – YANG METAL – YANG SOURCE
3. DISPERSE the Excess of YIN of the 6 GENERAL FUNCTIONS
YIN WATER especially.
4. Warm the cold and painful areas of the body or Meridians
III. THE ACTIONS OF MOXIBUSTION
Moxibustion is YANG energy from natural Plants, which are YANG.
Moxibustion warms the body, the cold areas and cold Meridians.
It stimulates blood circulation.
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Releases Obstructions.
Tones up the YANG.
WOOD – FIRE – EARTH – METAL – WATER – SOURCE
Is analgesic
Is tranquilizing
IV. THE METHODS OF MOXIBUSTION
1. The classical method of Moxibustion

Moxibustion with moxa roll
Moxibustion on the handle of the needle
2. Moxibustion with MOXA OIL and hairdryer or Infrared
PRACTICE

1 Apply
2 Disperse
3 Disrupt
4 Eliminate
5 Encourage
6 Expand
7 Modify
8 Penetrate
9 Rehabilitate
10 Succeed
1. Acupuncture can help ___________ the pain of tennis elbow, even after just one
treatment.
A. reduce B. relieve C. alleviate D. All are correct.
2. German researchers compared the effects of a single-needle acupuncture with a

placebo, ___________ procedure.
A. non-penetrative B. penetrative C. adhesive D. invasive
133
3. In the group receiving actual treatment, 55.8 per cent reported pain relief compared
with 15 per cent of those in the placebo group. Nearly 80 per cent of the acupuncture
group reported a reduction in pain of ___________ 50 per cent after only one treatment.
A. most B. least C. at least D. the most
4. ___________ is a family of procedures involving stimulation of anatomical locations

on or in the skin by a variety of techniques.
A. Moxibustion B. Acupuncture C. Massage D. Acupressure
5. Women who experience repeated bouts of urinary tract infections (UTI) have a good
chance of preventing ___________ episodes by abandoning antibiotics and using
acupuncture instead.
A. farther B. less C. the least D. further
6. Acupuncture may succeed where conventional medicine fails ___________ the pain
of fibromyalgia, a painful muscular condition.
A. to succeed B. in elevating C. in easing D. to manage
7. Acupuncture effectively relieves chronic low back pain. ___________ evidence

suggests that acupuncture is more effective than other active therapies.
A. No B. Without C. A D. The
8. Acupuncture is a form of alternative medicine. It is used most commonly for pain

relief, ___________ it is also used to treat a wide range of conditions.
A. in spite of B. despite C. though D. because
9. The most common mechanism of stimulation of acupuncture points ___________

penetration of the skin by thin metal needles, which are manipulated manually or the
needle may be further stimulated by electrical stimulation (electroacupuncture).
A. to employ B. employs C. employ D. employing
10. Needles vary in ___________ between 13 to 130 millimetres (0.51 to 5.12 in), with
shorter needles used near the face and eyes, and longer needles in areas with thicker
tissues; needle diameters vary from 0.16 mm (0.006 in) to 0.46 mm (0.018 in), with
thicker needles used on more robust patients.
A. weight B. thickness C. long D. length
1. Acupuncture research in the West is growing fast. Of course, the Chinese, Japanese,
A B
Koreans, Vietnamese and many other spend huge amounts on it too.
C D
2. Acupuncture research is also found an effective treatment for osteoarthritis.

A B C D
134
3. Acupuncture can help reducing the pain of tennis elbow, even after just one
A B C D
treatment.
4. Acupuncture is a component of the healthy care system of China that can be traced
A B C
back at least 2,500 years.
D
5. Acupuncture as a therapeutic intervention is wide practiced in the United States.

A B C D
6. Generally, side effects seem to relate to poor hygiene and train of the acupuncturist.
A B C D
7. Acupuncture is a form of alternative medicine in which thin needles inserted into the
A B C D
body.
8. Acupuncture is generally used only in combination with other form of treatment.

A B C D
9. Acupuncture is generally safety when done by an appropriately trained practitioner

A B C
using clean needle technique and single-use needles.
D
10. The skin is sterilized and needles inserted, frequently with a plastic guide tube.
A B C D
sentences.
1. The research at Southampton University, England took place over a number of years,
that measured how ___________ acupuncture relieved chronic pain associated with
these four pain conditions: chronic back and neck pain, osteoarthritis, shoulder pain,
and chronic headache. (good)
2. In two separate trials ___________ in the Annals of Internal Medicine, acupuncture

researchers found it was an effective pain reliever for people with neck pain and as an
effective treatment for sufferers of osteoarthritis. (publisher)
135
3. The practice of acupuncture to treat ___________ pathophysiological (disease)
conditions in American medicine was rare until the visit of President Richard M. Nixon to
China in 1972. (identify)
4. The FDA now regulates acupuncture needles, just as it does other devices such as
surgical scalpels and hypodermic syringes, under good manufacturing practices and
single-use standards of ___________. (sterile)
5. The most common serious injury reported from the needles of acupuncture has been
___________ puncture of the lung, which results in a partial collapse of the lung called
pneumothorax. (accident)
6. The most common infection reported from acupuncture treatments is ___________

hepatitis, a potentially serious infection of the liver. (virus)
7. Thinner needles may be flexible and require tubes for insertion. The tip of the needle
should not be made too sharp to prevent ___________, although blunt needles cause
more pain. (break)
8. Since most pain is felt in the superficial layers of the skin, a quick insertion of the
needle ___________. (recommendation)
10. Acupuncture can be painful. The skill level of the acupuncturist may influence how
painful the needle insertion is, and a ___________ skilled practitioner may be able to
insert the needles without causing any pain. (sufficiency)
Moxibustion on Needles
difficult repeated effective head needle

burns acupuncturist used transferred points
Since most acupuncture (1) _________ are beneath the surface of the skin, and since
manipulating a (2) _________ can attract the 'qi' to the point before warming it, many
acupuncturists insert and manipulate the needle first, then place moxa punk around the
(3) _________ of the needle before set it alight.
As the punk burns, its heat is (4) _________ down the shaft of the needle and directly
through the skin to the 'qi'. This can make their moxibustion very (5) _________. It is
also cleaner than moxa directly on the skin.
Dangers? That the moxa punk or its ash falls and (6) _________ the skin.
Acupuncturists guard against this by placing card round the base of the needles so that
if ash does fall, it falls onto the card not the skin.
136
Specially shaped spoons are often (7) _________ to remove the ash. Moxa on needles
can be (8) _________ many times, in different needles in different places on the body.
For the (9) _________, this can be like the circus act where many plates are kept
revolving on long poles on stage, but with experience it's not (10) _________.
What does your acupuncturist do?
Your acupuncturist aims to help your body throw the invader out.
In a perfect world, this means getting you to sweat properly, such sweat being an
indication that you've beaten the bug and need to cool down, and that presupposes that
your body achieves a healthy fever.
In practice, there's a huge theory to do with the invasion of disease into your body, and
what (s)he does depends on which bit of theory you display symptoms of.
In general, (s)he wants to get your Lungs working properly again.
She may use cupping on your back or chest, and acupuncture points chosen carefully
on channels that seem most affected. With herbs she may choose a recipe that
'releases the exterior'. Depending on her training and preference she may use Tuina or
Guasha, the former being a form of Chinese massage and the latter a kind of scraping.
I have found cupping and acupuncture often very effective.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
137
Acupuncture and how it works
Acupuncture involves inserting needles at certain points of the body. An acupuncturist

will insert needles into a person's body with the aim of balancing their energy. This, it is
claimed, can help boost wellbeing and may cure some illnesses. Conditions it is used
for include different kinds of pain, such as headaches, blood pressure problems, and
whooping cough, among others.
Traditional Chinese medicine explains that health is the result of a harmonious balance
of the complementary extremes of "yin" and "yang" of the life force known as "qi,"
pronounced "chi." Illness is said to be the consequence of an imbalance of the forces.
Qi is said to flow through meridians, or pathways, in the human body. These meridians
and energy flows are accessible through 350 acupuncture points in the body. Inserting
needles into these points with appropriate combinations is said to bring the energy flow
back into proper balance. There is no scientific proof that the meridians or acupuncture
points exist, and it is hard to prove that they either do or do not, but numerous studies
suggest that acupuncture works for some conditions.
Some experts have used neuroscience to explain acupuncture. Acupuncture points are
seen as places where nerves, muscles, and connective tissue can be stimulated. The
stimulation increases blood flow, while at the same time triggering the activity of the
body's natural painkillers. It is difficult to set up investigations using proper scientific
controls, because of the invasive nature of acupuncture. In a clinical study, a control
group would have to undergo sham treatment, or a placebo, for results to be compared
with those of genuine acupuncture. Some studies have concluded that acupuncture
offers similar benefits to a patient as a placebo, but others have indicated that there are
some real benefits.
Questions
1. What is balancing the energy in a person‘s body supposed to help?
______________________________________________________________________
______________________________________________________________________
2. In which conditions is acupuncture used for?
______________________________________________________________________
______________________________________________________________________
138
3. According to traditional Chinese medicine, how is health generally maintained?
______________________________________________________________________
______________________________________________________________________
4. What is said to bring the energy flow back into proper balance?
______________________________________________________________________
______________________________________________________________________
5. Why is it hard to set up investigations using proper scientific controls?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
139
UNIT
DISEASES
10
I. INTERNAL MEDICINE
Deep-source nasal congestion
Persistent nasal congestion with turbid snivel (nasal mucus) attributable to wind-cold,
wind-heat, or gallbladder heat.
Heat wind
Persistently remittent, usually intense headache attributed to win-cold or wind-heat

invasion and obstruction of the channels by phlegm or static blood. Head wind may be
accompanied by various other signs such as eye pain and loss of vision, runny nose,
nausea, dizziness, numbness or the head, or stiffness of the neck.
Consumption
A contagious disease characterized by cough with expectoration of blood, tidal heat

effusion, night sweating, and emaciation. In Western medicine, this disease is now
referred to as pulmonary tuberculosis.
Panting
Hasty, rapid, labored breathing with discontinuity between inhalation and exhalation, in
severe cases with gaping mouth, raised shoulders, flaring nostrils, and inability to lie
down. When associated with counterflow movement of qi, it is sometimes called
―painting counterflow‖. When breathing is usually rapid, it is sometimes called ―hasty
panting‖. When in severe cases, it is associated with raising of the shoulders and flaring
nostrils, it is ―raised-shoulder breathing‖. Panting is a manifestation of impaired diffusion
and downbearing of lung qi. Since the ―lung is the governor of qi‖ and the ―kidney is the
root of qi‖, panting is associated primarily with disease of the lung and/or kidney.
Panting occurs in repletion and vacuity. Repletion panting may occur when depressed
liver qi invades the lung, or when phlegm resulting from spleen-lung vacuity obstructs
the lung. Vacuity panting occurs in dual vacuity of lung yin and lung qi and also in
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kidney failing to absorb qi. Kidney vacuity with phlegm obstruction and yang vacuity
water flood are vacuity-repletion complexes that may also cause panting.
Wheezing
Hasty rapid breathing with phlegm rale in the throat
Whooping cough
A children‘s disease readily identifiable by the characteristic whoop of the cough. The
whooping sound is similar to the sound made by a hen after laying an egg, hence the
alternate name ―hen cough‖. Whooping cough is attributed to contraction of a seasonal
evil that causes phlegm turbidity to obstruct the airways and inhibit lung qi. If the cough
continues, it can damage the network vessels of the lung and cause expectoration of
blood.
Diptheria
A disease characterized by whitening of the throat. Diptheria occurs mostly in the

autumn or winter after a long period of dryness; it is attributed to seasonal epidemic
scourge toxin exploiting vacuity of the lung and stomach. It starts with a sore throat that
makes swallowing painful and with the appearance of white speckles on one or both
throat nodes, which spread quickly to create a white membrane that covers the uvula
and stretches into the regions inside and outside the throat pass. The membrane does
not easily slough off, cannot be forcefully removed without causing bleeding, and if
removed always grows back. Other signs include headache, generalized pain, slight
heat effusion (fever) or alternating (aversion to) cold and heat (effusion), lack of spirit,
oppression in the chest, vexation and agitation, bad breath, and nasal congestion. If the
white membrane spreads into the region inside the throat pass and down to the
epiglottis and beyond, signs such as labored breathing, flaring nostrils, green-blue lips,
heart palpitations or fearful throbbing, and a bound or intermittent pulse may be
observed. Distinction is made between yang heat and yin vacuity patterns. Yang heat
patterns are attributed to wind-heat or heat toxin and are characterized by a red sore
swollen throat, heat effusion (fever), constipation, and reddish urine; yin vacuity patterns
are attributed to dryness-heat damaging the lung and stomach and are characterized by
white putrid throat, low fever, heat in the hearts of the palms and soles, fatigue,
shortness of breath, and a fine rapid pulse.
Throat impediment
Critical swelling and soreness of the throat in which the throat becomes severely
occluded.
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Nipple moth; baby moth
Redness, swelling, and soreness of either or both of the throat nodes (tonsils) with a
yellowish white discharge visible on their surface. Baby moth is attributable to a)
congesting lung-stomach heat with fire toxin steaming upward; b) qi stagnation and
congealing blood together with old phlegm and liver fire binding to form malign blood; or
c) liver-kidney yin-liquid depletion with vacuity fire flaming upward; or c) liver-kidney yin-
liquid depletion with vacuity fire flaming upward. Accompanying signs include
constipation, a thick slimy tongue fur, difficulty in swallowing fluids, and alternating
(aversion to) cold and heat (effusion). This condition corresponds to tonsillitis.
Single moth
Baby moth on one side of the throat
Double moth
Baby moth on both sides of the throat
Ununited skull
Retarded closure of the fontanel gate
Measles
A transmissible disease that mostly affects children and that is characterized by

eruption of papules the shape of sesame seeds. The disease is located in the spleen
and lung channels and can affect other bowels and viscera. Measles is characterized at
onset by heat effusion (fever), cough, copious tearing, and white speckles inside the
mouth. After three days of heat effusion, papules appear behind the ears and on the
neck and face, and they spread to the limbs. Eruptions are complete when the papules
reach the legs.
Mumps
A febrile disease characterized by soft diffuse swelling and tenderness that affects one
side of the face or one side after the other. Mumps is attributed to accumulated
gastrointestinal heat and to depressed liver with gallbladder fire that arises after
contraction of warm toxin and causes blockage of the lesser yang. It occurs in
epidermics in the winter and spring, and chiefly affects children.
Smallpox
A disease characterized by heat effusion (fever), cough, sneezing, yawning, red face,
fright palpitations, cold extremities and ears, and eruption of pox.
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Pox
Eruptive diseases such as smallpox and measles
Impediment
Any disease pattern that results from blockage of the channels occuring when wind,
cold, and dampness invade the fleshy exterior and the joints, and that manifests in signs
such as joint pain, sinew and bone pain, and heaviness or numbness of the limbs.
Joint-running wind
A disease characterized by redness and swelling of the joints, with acute pain and
difficulty bending and stretching. Joint-running wind is attributed to transformation of
wind-cold-damp into heat in patients suffering from liver-kidney vacuity, and it falls the
scope of impediment.
Crane’s-knee wind
A disease marked by a painful suppurative swelling of the knee associated with

emaciation of the lower leg. Crane‘s-knee wind is attributed to depletion of kidney yin
and to depletion of the three yang channels allowing the invasion of cold-damp, which
causes congealing stagnation; in most cases it develops from joint-running wind.
Crane‘s-knee wind starts with physical cold and heat effusion, slight swelling of the
knee, difficulty walking, and local pain. As it progresses, the knee becomes red,
swollen, and hot or white with diffuse swelling. The thigh and calf become thin, and the
swelling at the knee bursts to produce fluid pus or a thick yellow humor. Crane‘s knee
wind heals with difficulty.
Crick in the neck
Stiffness of the neck that results from taxation fatigue (overwork, etc.), twisting, sleeping
in the wrong posture, or from exposure to a draft (wind-cold).
Wilting
Any disease pattern characterized by weakness and limpness of the sinews. In severe
cases it prevents the lifting of the arms and legs and is accompanied by the sensation
that the elbow, wrist, knee, and ankle are dislocated. In advanced cases, atrophy sets
in. In clinical practice, the condition is mainly found to affect the legs and prevent the
patient from walking, hence it is also called ―crippling wilt‖. Wilting patterns include
withering and paralysis of the limbs after high fever in neonates and infants, which
Western medicine attributes to poliomyelitis.
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Plum-pit qi
Dryness and a sensation in the throat of a foreign body that can be neither swallowed
nor ejected. The intensity of the signs fluctuates. The main cause is binding depression
of liver qi. Plum-pit qi corresponds to globus hystericus in Western medicine.
Dysphagia-occlusion
A disease characterized by sensation of blockage on swallowing, difficulty in getting

food and drink down, and, in some cases, immediate vomiting of ingested food.
Dysphagia and occlusion may occur independently. Dysphagia most commonly but not
necessarily develops into occlusion. There are four principal patterns: 1) phlegm and qi
obstructing each other, 2) liquid depletion and heat bind, 3) static blood binding
internally, and 4) qi vacuity and yang debilitation.
Stomach reflux
A disease pattern characterized by distention and fullness after eating, either vomiting in
the evening of food ingested in the morning or vomiting in the morning of food ingested
in the evening (i.e., vomiting a long time after eating) with untransformed food in the
vomitus, lassitude of spirit, and lack of bodily strength. Its principal cause is spleen-
stomach vacuity cold, but it may also be due to debilitation of the life gate fire or to dual
vacuity of qi and yin.
Cholera; sudden turmoil
A disease characterized by severe cramps. Dry cholera is characterized by an

ungratified urge to vomit and defecate at the same time. Cholera in Chinese medicine
comprises what modern Western medicine calls cholera as well as acute gastroenteritis
presenting with the same signs.
Dysentery
A disease characterized by abdominal pain, tenesmus, and stool containing pus and
blood (described as mucoid and bloody stool in Western medicine). Dysentery usually
occurs in hot weather and arises when gastrointestinal vacuity and eating raw, cold, or
unclean food allow damp-heat or other evils to brew in the intestines. It takes the form of
vacuity or repletion. Depending on the cause, distinction is made between summer-heat
dysentery, damp-heat dysentery, cold dysentery, and heat dysentery. Depending on the
nature of the stool, distinction is made between red dysentery (blood in the stool), white
dysentery (pus in the stool), and red and white dysentery (stool containing pus and
blood).
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Jaundice
A condition characterized by the three classic signs of yellow skin, yellow eyes, and
yellow urine, i.e., generalized yellowing of the body, yellowing of the whites of the eyes
(sclera), and darker-than-normal urine. Jaundice occurs when contraction of seasonal
evils or dietary irregularities cause damp-heat or cold-damp to obstruct the center
burner, preventing bile from flowing according to its normal course.
Tetany
Severe spasm such as rigidity in the neck, clenched jaw, convulsions of the limbs, and
arched-back rigidity. In severe cases, there is clouding reversal (loss of consciousness),
which is often referred to as ―tetanic reversal‖. Repletion patterns are attributed to wind,
cold, dampness, phlegm, or fire congesting the channels, whereas vacuity patterns
occur when excessive sweating, loss of blood, or constitutional vacuity causes qi
vacuity, shortage of blood, and insufficiency of the fluids, which deprive the sinews of
nourishment and allow internal wind to stir. To resolve tetany, repletion patterns are
treated primarily by dispelling wind and secondarily by supporting right qi, whereas
vacuity patterns are treated primarily by boosting qi and nourishing the blood and
secondarily by extinguishing wind. Distinction is made between ―soft tetany‖ and ―hard
tetany‖, the former being distinguished from the latter by the presence of sweating and
absence of aversion to cold. The terms yin tetany and yang tetany are synonymous with
soft ad hard tetany, or may denote tetany with and without counterflow cold of the limbs,
respectively. Tetany may occur as a sign of a variety of different diseases, including, but
not limited to, tetanus; occurring in infants and children, it is referred to as fight wind.
Child fright wind
A disease of infants and children, characterized by convulsions and loss of

consciousness. Fright wind is equivalent to tetany in adults. Distinction is made between
acute and chronic forms: acute fright wind and chronic fright wind.
Malaria
A recurrent disease that is characterized by shivering, vigorous heat (effusion), and

sweating and that is classically attributed to contraction of summerheat during the hot
season, contact with ―mountain forest miasma‖, or contraction of cold-damp. Malaria is
explained as evil qi latent at midstage (half-exterior and half-interior). Different forms are
distinguished according to signs and causes.
Heart impediment
A disease of the heart that is characterised by pain and by suffocating oppression and
that is caused by stasis obstruction of the heart vessels. Elementary Question states,
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―Heart impediment is stoppage in the vessels…‖ The stoppage may actually be due to
a) an inadequate warming and propulsion of the blood as a result of insufficiency of
yang qi or b) an obstruction of the heart vessels by static blood that forms when internal
phlegm turbidity impedes blood flow. Signs of heart impediment include dull pain and
stifling oppression in the chest, which are attributed to impaired yang qi perfusion or
obstruction of the network vessels by phlegm stasis (blood stasis resulting from the
presence of phlegm). Attacks are characterised by gripping pain in the heart (angina
pectoris), green-blue or purple complexion, cold limbs, and a faint fine pulse verging on
expiration, which indicate severe obstruction of heart qi and heart yang. Heart
palpitations, fearful throbbing, fatigued spirit, and shortness of breath are signs of heart
qi vacuity between attacks.
Running piglet
A sensation of upsurge from the lower abdomen to the chest and throat, accompanied
by gripping abdominal pain, oppression in the chest, rapid breathing, dizziness, heart
palpitations, and heart vexation. This pattern results from an upsurging of yin cold qi of
the kidney or from liver channel qi fire ascending counterflow.
Drum distension or severe abdominal distension is attributed by a variety of causes

and usually involves spleen disease affecting the liver or liver and spleen disease
affecting the kidney.
Dispersion thirst
Any disease characterised by thirst, increased fluid intake, and copious urine.
Dispersion thirst is categorized as upper burner, center burner, and lower burner
dispersion, depending on the pathomechanism. It includes conditions diagnosed in
Western medicine as diabetes mellitus.
Concretions, conglomerations, accumulations, and gatherings
Four kinds of abdominal masses associated with pain and distension. Concretions and
accumulations are masses of definite form and fixed location that are associated with
pain and fixed location. They stem from disease in the viscera and blood aspect.
Conglomerations and gatherings are masses of indefinite form that gather and dissipate
at irregular intervals and are attended by pain of unfixed location. They are attributed to
disease in the bowels and qi aspect. Accumulations and gatherings chiefly occur in the
center burner. Concretions and conglomerations chiefly occur in the lower burner and in
many cases are the result of gynecological diseases. In general, concretions,
conglomerations, accumulations, and gatherings arise when emotional depression or
dietary intemperance causes damage to the liver and spleen. The resultant organ
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disharmony leads to obstruction and stagnation of qi, which in turn causes static blood
to collect gradually. Most often the root cause is insufficiency of right qi.
Mounting
Any of various diseases characterised by pain or swelling of the abdomen or scrotum.

Traditional literature describes many different diseases and patterns labeled as
―mounting‖. Mounting disease can be divided into three categories: (1) conditions
characterised by the protrusion of the abdominal contents through the abdominal wall,
the inguen, or the base of the abdominal cavity, and usually associated with qi pain.
This corresponds to hernia in Western medicine; (2) various diseases of the external
genitals, including conditions known as hydrocele and hematoma of the testis in
Western medicine. In traditional literature, scrotal conditions are sometimes referred to
as ―unilateral sagging (of the testicles)‖; (3) certain forms of acute abdominal pain
associated with urinary and fecal stoppage.
Wind stroke/ wind strike
A disease characterised by the sudden appearance of hemiplegia, deviated eyes and

mouth, and impeded speech that may or may not start with sudden clouding collapse.
Wind stroke occurs a) when depletion of yin essence or sudden anger causes
hyperactivity of liver yang that stirs liver wind; b) when, owing to a predilection for rich,
fatty foods, phlegm-heat congests in the inner body and transforms into wind; c) when
vacuity of qui and blood causes vacuity wind; or d) when a patient suffering from
internal vacuity suddenly contracts external wind. Distinction can be made between: a)
channel and network (vessel) stroke, which is marked by deviated eyes and mouth,
inhibited speech, and hemiplegia with no change in spirit-mind; and b) bowel and
visceral stroke, marked by sudden collapse and loss of consciousness. Bowel and
visceral stroke can be divided into block patterns characterised by clenched jaw and
clenched hands and desertion patterns marked by closed eyes and open mouth, limp
hand and snoring nose, urinary and fecal incontinence, and in some cases by
spontaneous sweating.
Epilepsy
A disease characterised by brief episodes (fits) of temporary loss of spirit, white

complexion, and fixity of the eyes, or sudden clouding collapse, foaming at the mouth,
upward-staring eyes, clenched jaw, convulsions of the limbs, and in some cases
squealing like a goat or pig. After an episode, the patient experiences fatigue and then
returns to normal. Epilepsy is attributed to fear and fright or emotional imbalance,
dietary irregularities, and taxation damaging the liver, spleen, and kidney channels and
causing wind-phlegm to be carried upward by qi.
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Mania and Withdrawal – Mental derangement
Mania denotes stages of excitement characterised by noisy, unruly, and even

aggressive behaviour, offensive speech, constant singing and laughter, irascibility,
springing walls and climbing roofs, and inability to remain tidily dressed. This is a yang
pattern of the heart spirit straying outward owing to hyperactivity of yang qi. Withdrawal
refers to emotional depression, indifference, deranged speech, taciturnity, and
obliviousness of hunger or satiety. It is a yin pattern caused by binding of depressed qi
and phlegm or heart-spleen vacuity.
Lockjaw
Tetany that occurs when an external injury or mouth sores permit the invasion of wind
evil. Lockjaw begins with lack of strength in the limbs, headache, pain in the cheeks,
clenched jaw, difficulty in turning the neck, the heat effusion (fever) and aversion to
cold. Subsequently, there is a spasm of the facial muscles that creates the appearance
of a strange grimace, tightly clenched jaw, stiff tongue, drooling, intermittent
gerneralised spasm, and arched-back rigidity. The pulse is rapid or tight and stringlike.
Finally, speech, swallowing, and breathing all become difficult, and, in the worst cases,
the patient dies of asphyxiation.
Dribbling urinary block
Dribbling urination or, in severe cases, almost complete blockage of urine flow.
Distinction is made between a number of vacuity and repletion patterns. Vacuity
patterns include insufficiency of center qi and kidney qi vacuity. The repletion patterns
include lower burner damp-heat, lung qi congestion, binding depression of liver qi, and
urinary tract stasis blockage.
Water swelling
Swelling of the flesh that occurs when dysfunction of the spleen, kidney, and lung due to
internal or external causes allows water to accumulate. It is attributed to spleen-kidney
yang vacuity or external evils impairing the diffusion of lung qi.
Strangury pattern
Any of several disease patterns characterised by urinary urgency, frequent short painful
rough voidings, and dribbling incontinence. Strangury is attributed to damp-heat
gathering and pouring into the bladder. In persistent conditions or in elderly or weak
patients, the cause may be center qi fall or kidney vacuity with impaired qi
transformation. Distinction is made between stone strangury, qi strangury, blood
strangury, unctuous strangury, and taxation strangury, known collectively as the ―five
stranguries‖.
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Flooding and spotting
Any abnormal discharge of blood via the vagina. Flooding is heavy menstrual flow or
abnormal bleeding via the vagina (uterine bleeding); spotting, ―leaking‖ in Chinese, is a
slight, often continual discharge of blood via the vagina. It the flow is deep red and
clotted, it is usually a sign of heat. Since each may give way to the other, they are
commonly referred to together. Flooding and spotting usually occur in puberty or at
menopause. They are attributed to insecurity of the thoroughfare and controlling
vessels, which may stem from a variety of causes.
Malign obstruction; morning sickness
A condition of aversion to food, nausea, and vomiting during pregnancy, not considered
untoward unless it severely affects the food intake. Malign obstruction is the
manifestation of impaired harmonious downbearing of stomach qi, which may be due to
causes such as liver heat, phlegm stagnation, stomach cold, or stomach heat. In
Western medicine, it is called emesis gravidarum and is commonly referred to as
―morning sickness‖.
Retention of the lochia - Absence of normal postpartum discharge
Retention of the lochia is when cold evil exploits the sudden vacuity of qi and blood
created by childbirth and invades the uterine vessels, where it congeals and causes
blood stasis. It may also arise in patients with constitutional vacuity when damage to qi
and blood through childbirth causes sluggish movement of the blood.
Infertility
It is the inability to become pregnant between menarche and menopause. In clinical

practice, a woman who fails to become pregnant within three years of normal conjugal
life without the use of contraception is considered infertile. Chinese medicine recognizes
congenital factors and acquired factors.
Yin protrusion
A woman‘s disease characterised by heaviness, sagging, and swelling of the anterior

yin or the hanging of the interior outside the body. Yin protrusion is usually the result of
center qi fall or insufficiency of kidney qi, if not due to holding the breath and straining in
childbirth. The center qi fall pattern is one of vacuity and includes signs such as sagging
sensation in the abdomen, heart palpitations, shortness of breath, lassitude of spirit,
vaginal discharge, and a floating vacuous pulse. Kidney vacuity is identified by the
presence of limp aching lumbus and knees. If there is redness, swelling, and exudation
of yellow water, as is often the case when friction causes damage, the pattern is
considered to be one of damp-heat pouring downward; this condition may also be
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identified by a burning sensation on urination, heart vexation, spontaneous sweating, a
dry mouth with bitter taste, and a slippery rapid pulse.
Pulmonary welling-abscess – A welling-abscess in the lung
It occurs externally contracted wind evil and heat toxin brew and obstruct the lung, and
when the heat causes congestion and blood stasis, which binds to form a welling-
abscess that in time starts to suppurate. The classic sign is coughing up pus and blood.
Pulmonary welling-abscess is associated with heat effusion (fever) and shivering, and
with cough, chest pain, rapid respiration, expectoration of sticky fishy-smelling purulent
phlegm, and in severe cases expectoration of phlegm and blood.
Intestinal welling-abscess - Welling-abscess of the intestine
It is attributed to congealing blood that stem from damp-heat or from general qi and
blood stagnation. It corresponds to appendicitis or periappendicular abscess in Western
medicine.
Lung wilting
A chronic condition characterised by a dull-sounding cough, ejection of thick turbid

foamy drool, panting at the slightest exertion, dry mouth and pharynx, emaciation, red
dry tongue, and a vacuous rapid pulse. In some cases, there may be tidal heat
(effusion), and, in severe cases, the skin and hair may become dry. It is attributed to
dryness-heat and enduring cough damaging the lung, or damage to fluid due to disease
depriving the lung of moisturization.
Spontaneous external bleeding
Bleeding not attributable to external injury, especially nosebleed. It includes nosebleed,

spontaneous bleeding of the nipple, spontaneous bleeding of the ear, spontaneous
bleeding of the flesh, spontaneous bleeding of the gums, and spontaneous bleeding of
the tongue.
Goiter
Swelling at the front and sides of the neck that moves up and down as the patient
swallows. In Western medicine, goiter is usually enlargement of the thyroid gland.
B. EXTERNAL MEDICNE DISEASES
Sore
A generic term for diseases of external medicine, such as welling-abscess, flat-abscess,

clove sore, boil, streaming sore, and scrofula, generally caused by toxic evils invading
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the body, evil heat scorching the blood, and congestion of qi and blood. Sores are
treated differently according to whether they are yin or yang, according to their stage of
development, and according to the channel affected.
Welling-abscess
A large suppuration in the flesh characterised by a painful swelling and redness that is
clearly circumscribed, and that before rupturing is soft and characterised by a thin shiny
skin. Before suppuration begins, it can be easily dispersed; when pus has formed, it
easily ruptures; after rupture, it easily closes and heals. It may be associated with
generalised heat (effusion), thirst, yellow tongue fur, and a rapid pulse.
Flat-abscess
A deep malign suppuration in the flesh, sinew, and even the bone, attributed to toxic evil
obstructing qi and blood.
Boil
A small, round, superficial swelling that is hot and painful, suppurates within a few days,
not easily bursts. It is attributable to heat toxin or to summerheat-heat and usually
occurs in the summer and autumn.
Clove sore
A small, hard sore with a deep root like a clove or nail, appearing most commonly on
the face and ends of the fingers. It occurs when fire toxin enters the body through the
wound, and then heat brew and binds in the skin and flesh. It may also occurs when
anger, anxiety, and preoccupation or excessive indulgence in rich food or alcohol lead
to accumulated heat in the bowels and viscera, which effuses outward to the skin. A
clove sore may sometimes have a single red threadlike line stretching from the sore
toward the trunk. This is known as a ―red-thread clove sore.‖ Severe forms are known
as toxin clove sores, whose toxin can spread to penetrate the blood aspect and attack
the bowels and viscera, causing clouded spirit. This is called ―running yellow‖.
Scrofula
Lumps beneath the skin on the side of the neck and under the armpits. These are often
referred to in older books as ―saber and pearl-string lumps‖ because of the saber-like
formation they can make below the armpit and the necklace-like formation they can
make on the neck. Scrofula occurs when phlegm gathers in the neck, armpits, or groin.
The phlegm is produced when vacuity fire occurring in lung-kidney vacuity scorches the
fluids. In some cases, wind-fire evil toxin is also a factor.
Phlegm node
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Any lump below the skin that feels soft and slippery under the finger, is associated with
no redness, pain, or swelling, and (unlike scrofula) does not suppurate.
Streaming sore
A suppuration deep in the body that is so called because of the tendency of its toxin to
move from one place to another, as if flowing through the flesh. A streaming sore begins
with a lump or diffuse swelling of the flesh. Pus forms, and after rupture and thorough
drainage, the sore can heal.
Scab
A disease characterised by small papules the size of a pinhead that are associated with
insufferable penetrating itching and that, when scratched, many suppurate or crust
without producing any exudate. Scab commonly occurs between the fingers and may
also be observed on the inside of the elbow, in the armpits, on the lower abdomen, in
the groin, and on the buttocks and thighs, and, in severe cases, over the whole body. It
is attributed to damp-heat depressed in the skin and is transmitted by contact.
Lichen
A skin disease characterized by elevation of the skin, serous discharge, scaling, and
itching. Lichen is associated with wind, heat, and dampness. Lichen characterized by
dryness and scaling of the skin is called ―dry lichen‖, whereas lichen that exudes a
discharge is called damp lichen.
Mouth sore
A pale yellow or gray-white ulceration appearing singly or multiply on the inside of the
mouth (lips, cheeks, or palate). Usual oval in shape, a mouth sore is surrounded by a
red areola and has a cratered surface. It is associated with scorching pain, affects
eating and swallowing, and is current. It is attributed to repletion fire, spleen heat
engendering phlegm, or dual vacuity of the spleen and kidney. Mouth sores are called
aphthous stomatitis in Western medicine.
Frotbite: severe damage to the skin and flesh that occurs when cold and wind cause qi
and blood to congeal and stagnate. Frostbite usually affects the hands, feet, and ears.
The affected areas present a somber white complexion that gradually turns purple-red
and forms macules. This is associated with a burning sensation, itching, and numbness.
In severe cases, the macules rupture, giving way to sores that heal with difficulty.
Frostbite can be prevented by adequate clothing and physical movement.
Erysipelas; cinnabar toxin (sore): a condition characterized by sudden localized

reddening of the skin, giving it the appearance of having been smeared with cinnabar.
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Cinnabar toxin usually affects the face and lower legs, is most common among children
and the elderly, and usually occurs in spring and summer. Cinnabar toxin is known by
different names according to form and location. When it affects the head, it is called
―head fire cinnabar‖. When it assumes a wandering pattern, it si called ―wandering
cinnabar‖ , as is obserbed in newborns. Cinnabar toxin of the lower legs is called ―fire
flow‖ or ―fire cinnabar leg‖. Cinnabar toxin occurs when damaged skin and insecurity of
defense qi allow evil toxin to enter the body and cause heat in the blood aspect, which
becomes trapped in the skin. If the toxin is accompanied by wind, the face is affected; if
accompanied by dampness, the lower legs are affected. Thus, the facial type tends to
be wind-heat, whereas the lower leg type is damp-heat. The disesase develops swiftly.
Sprain
Damage to the sinew and flesh and to blood vessels around the joints such as the
shoulder, elbow, wrist, lumbus, hip, knee, and ankle joints, due to twisting, pulling, or
knocks and falls. Sprains are characterized by pain, by swelling, and by discoloration of
the skin due to stasis and blockage. Red indicates damage to the skin and flesh; blue-
green indicates damage to the sinews; purple indicates blood stasis. Slight local
swelling and tenderness indicate mild injury. Pronounced swelling and difficulty in
flexing the joint are signs of a severe pain.
PRACTICE
VERBS NOUNS MEANINGS

1 obstruct
2 erupt
3 expose
4 contract
5 expectorate
6 explain
7 exhale
8 inhale
9 accumulate
10 suggest
1. Head wind may be __________ by various other signs such as eye pain and loss of
vision, runny nose, nausea, dizziness, numbness or the head, or stiffness of the neck.
A. accompanied B associated C. comprised D. composed
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2. Kidney vacuity with phlegm __________ and yang vacuity water flood are vacuity-
repletion complexes that may also cause panting.
A. production B. construction C. contraction D. obstruction
3. After three days of heat effusion, papules appear behind the ears and on the neck
and face, and they __________ to the limbs.
A. connect B. link C. spread D. result
4. Mumps is a febrile disease characterized __________ soft diffuse swelling and

tenderness that affects one side of the face or one side after the other.
A. by B. with C. in D. on
5. __________ is a disease characterized by heat effusion (fever), cough, sneezing,

yawning, red face, fright palpitations, cold extremities and ears, and eruption of pox.
A. Mumps B. Smallpox C. Flu D. Chickenpox
6. Crick in the neck is stiffness of the neck __________ from taxation fatigue (overwork,
etc.), twisting, sleeping in the wrong posture, or from exposure to a draft (wind-cold).
A. which result B. resulted C. that results D. result
7. The principal cause of stomach reflux is spleen-stomach vacuity cold, but it may also
be __________debilitation of the life gate fire or to dual vacuity of qi and yin.
A. because B. due to C. despite D. in spite of
8. Dysentery usually occurs in hot weather and arises when gastrointestinal vacuity and
eating raw, cold, or unclean food allow damp-heat or other evils to brew in the
__________.
A. stomach B. pharynx C. esophagus D. intestines
9. Jaundice occurs when __________ of seasonal evils or dietary irregularities cause

damp-heat or cold-damp to obstruct the center burner, preventing bile from flowing
according to its normal course.
A. relaxation B. transmission C. contraction D. conduction
10. Heart impediment is a disease of the heart that is characterised by pain and by
suffocating oppression and that is __________ by stasis obstruction of the heart
vessels.
A. led B. caused C. produced D. occured
1. A contagious disease characterized by cough with expectorate of blood, tidal heat

A B C
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effusion, night sweating, and emaciation.
D
2. Panting is a manifest of impaired diffusion and downbearing of lung qi.

A B C D
3. If the cough continues, it can damage the network vessels of the lung and causing
A B C
expectoration of blood.
D
4. Measles is a transmissible disease that mostly affect children and that is

A B
characterized by eruption of papules the shape of sesame seeds.

C D
5. Crane‘s-knee wind is a disease mark by a painful suppurative swelling of the knee

A B
associated with emaciation of the lower leg.

C D
6. Wilting is any disease pattern characterized by weak and limpness of the sinews.
A B C D
7. Dry cholera is characterized by an ungratified urge to vomit and defecation at the

A B C D
same time.
8. Tetany may occur as a sign of a vary of different diseases, including, but not limited
A B
to, tetanus; occurring in infants and children, it is referred to as fight wind.

C D
9. Malaria is explained with evil qi latent at midstage (half-exterior and half-interior).

A B
Different forms are distinguished according to signs and causes.

C D
10. Mounting is any of vary diseases characterised by pain or swelling of the abdomen
A B C D
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or scrotum.
sentences.
1. Hasty, rapid, labored breathing with discontinuity between __________ and

exhalation, in severe cases with gaping mouth, raised shoulders, flaring nostrils, and
inability to lie down. (inhale)
2. Diptheria occurs mostly in the autumn or winter after a long period of __________; it
is attributed to seasonal epidemic scourge toxin exploiting vacuity of the lung and
stomach. (dry)
3. Yang heat patterns are attributed to wind-heat or heat toxin and are characterized by
a red sore swollen throat, heat effusion (fever), constipation, and reddish urine; yin
vacuity patterns are attributed to dryness-heat damaging the lung and stomach and are
characterized by white putrid throat, low fever, heat in the hearts of the palms and soles,
fatigue, __________ of breath, and a fine rapid pulse. (short)
4. Whooping cough is attributed to contraction of a seasonal evil that causes phlegm

turbidity to obstruct the airways and inhibit lung qi.
5. Dysphagia-occlusion is a disease characterized by sensation of blockage on

swallowing, __________ in getting food and drink down, and, in some cases, immediate
vomiting of ingested food. (difficult)
6. Dysentery is a disease characterized by abdominal pain, tenesmus, and stool

containing pus and blood (described as mucoid and __________ stool in Western
medicine). (blood)
7. Jaundice is a condition __________ by the three classic signs of yellow skin, yellow
eyes, and yellow urine, i.e., generalized yellowing of the body, yellowing of the whites of
the eyes (sclera), and darker-than-normal urine. (characteristics)
8. Drum distension or severe __________ distension is attributed by a variety of causes

and usually involves spleen disease affecting the liver or liver and spleen disease
affecting the kidney. (abdomen)
9. Dispersion thirst is any disease characterised by thirst, increased fluid intake, and
copious urine. Dispersion thirst is __________ as upper burner, center burner, and
lower burner dispersion, depending on the pathomechanism. (category)
10. Accumulations and gatherings chiefly occur in the center burner. Concretions and
conglomerations chiefly occur in the lower burner and in many cases are the result of
__________ diseases. (gynecology)
156
First Steps in Using Yin Yang Theory for Insomnia
reduce inject prevent soft warmth
cold noise sleep brain stretch
If you grasped the balloon analogy above, you'll realise that where you (1) __________
should have Yin characteristics.
A comfortable bed - big enough for you and any others to sleep without disturbing one
another and for you to (2) __________ without banging your head or your feet on the
bed-ends;
A comfortable mattress: some people like firm mattresses, others prefer (3)
__________ mattresses but whichever, your mattress should be flat, not concave,
and thick enough to prevent you losing (4) __________ (eg to the ground
underneath), but not so insulating that you feel like you're lying on hot coals;
Reduced noise: babies can often sleep through a hurricane but adults can't. Loud or
intermittent or varying levels of noise can (5) __________ deep sleep. Some noises
help you get to sleep and may help keep you there, such as the (6) __________ of
rain on leaves, or of gentle sea waves. Nowadays there are sound-tracks that help your
(7) __________ sink into meditative brainwave patterns similar to those in deep
sleep;
Air that is neither too hot or too (8) __________ , and that is not too dry (dry and hot
are Yang). Opinions vary on what is best but definitely a cool room is better than a hot
room. For some, a warm room that cools gradually is just right.
An absence of invading beasts, including mosquitoes and bed bugs, that (9)
__________ their pathogens and irritate your skin;
Darkness: although some people fear darkness, our eyes bring (Yang) light energy into
our brains, and at night we want to (10) __________ Yang, so darkness is better. If
you need light to calm anxieties while getting to sleep, see if you can arrange a timer to
turn it off after say 30 minutes by when you will normally be asleep. Recent research
suggests that too much light during sleep induces an increase in BMI and obesity.
Why is it called WIND-HEAT?
Chinese medicine often uses analogies to describe conditions. If you think of the Wind,
you probably think of movement. Depending on its strength you may hear leaves
fluttering in the breeze, or you may see cars overturned. Wind, in Chinese medicine, is
the same. Shivering and trembling are signs of Wind, and so is rushing around and
noise and sudden change.
157
The Wind affects the upper parts of our body more than other parts, just as winds on
mountain-tops are much stronger. So with Wind-heat, the wind makes us alternately hot
and cold, sneezing, restless and disruptive.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Herbal Medicine Today: Clinical and Research Issues

Herbal medicine is the use of medicinal plants for prevention and treatment of diseases:
it ranges from traditional and popular medicines of every country to the use of
standardized and tritated herbal extracts. Generally cultural rootedness enduring and
widespread use in a Traditional Medical System may indicate safety, but not efficacy of
treatments, especially in herbal medicine where tradition is almost completely based on
remedies containing active principles at very low and ultra low concentrations, or relying
on magical-energetic principles.
In the age of globalization and of the so-called ‗plate world‘, assessing the
‗transferability‘ of treatments between different cultures is not a relevant goal for clinical
research, while are the assessment of efficacy and safety that should be based on the
regular patterns of mainstream clinical medicine.
The other black box of herbal-based treatments is the lack of definite and complete
information about the composition of extracts. Herbal derived remedies need a powerful
and deep assessment of their pharmacological qualities and safety that actually can be
realized by new biologic technologies like pharmacogenomic, metabolomic and
microarray methodology. Because of the large and growing use of natural derived
substances in all over the world, it is not wise to rely also on the tradition or supposed
millenarian beliefs; explanatory and pragmatic studies are useful and should be
considered complementary in the acquisition of reliable data both for health caregiver
and patients.
158
Questions
1. How is herbal medicine defined according to the passage?
______________________________________________________________________
______________________________________________________________________
2. What is the range of herbal medicine mentioned in the passage?
______________________________________________________________________
______________________________________________________________________
3. What is considered not a relevant goal for clinical research in the age of globalization
and of the so-called ‗plate world‘?
______________________________________________________________________
______________________________________________________________________
4. What is mentioned as one drawback of herbal-based treatments?
______________________________________________________________________
______________________________________________________________________
5. Why is it not wise to rely also on the tradition or supposed millenarian beliefs?
______________________________________________________________________
______________________________________________________________________
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
6. __________________________________________________________________________
7. __________________________________________________________________________
8. __________________________________________________________________________
9. __________________________________________________________________________
10. _________________________________________________________________________
159
APPENDIX
TEST YOUR VOCABULARY
TEST YOUR VOCABULARY 1: TRADITIONAL MEDICINE
MATCHING EXERCISE: MATCH GROUP 1 WITH GROUP 2
GROUP 1
1. Health
2. Illness
3. Natural recovery in the setting of alternative therapies
4. Modern vs. traditional epidemiology
5. Health protection in traditional medicine
6. allopathic vs. homeopathic philosophies
7. homeopathic
8. osteopathic
9. chiropractic
10. CAM
11. Ayurveda (Indian)
12. Curanderismo (Latin American)
13. Qi gong (Chinese)
14. Reiki (Japanese)
15. Santeria (Cuba/Brazil)
16. Voodoo (Haiti)
GROUP 2
A.
Supreme god rules over large pantheon of local and tutelary deities, ancestors, and
160
saints that communicate in dreams, trances, and ritual possessions.
B.
Curanderismo (Latin American)
blends religious beliefs, faith, and prayer with the use of herbs, massage, and other
traditional methods
C.
treatment consists of minute doses of plant, animal, or mineral substances
D.
Japanese technique for stress reduction and relaxation. Administered by laying on
hands and based on idea of unseen "life force energy"
E.
A system of health care that persons may elect to use that is generic and not a part of
their personal heritage
Ex: aromatherapy, biofeedback, hypnotherapy, etc.
F.
a highly personal state in which the person feels unhealthy or ill, may or may not be
related to disease
G.
Sacred objects worn on body or hung in home or at work. Examples include: bangles,
talisman, garlic and onion, or ginseng root. Also, balanced diets or avoidance of foods
H.
-Based on concept that the body can formulate its own remedies against disease when
working properly
-Holisitic, but embraces modern medicine
I.
Attempts to explain a phenomenon that is natural.
Ex: Cold sx for 7 days, better by day 10 without intervention
Cold sx for 7 days, better by day 10 with abx
J.
System of beliefs that merge Yoruba religion, Roman Catholic, and Native American.
Trance for communicating with ancestors and deities, animal sacrifice, and sacred
drumming
K.
Modern - caused by pathogens
Traditional - spells, hexes, possession, evil eye, etc.
161
L.
Allopathic is more concerned with treating the disease while homeopathic treats the
whole person
M.
interference with the normal transmission of mental impulses between brain and body
caused by misalignment or subluxation of vertebrae
N.
Integrates physical postures, breathing techniques, and focused intention
O.
Looks at human body in terms of earth, wind, fire, air, and ether as well as wind, bile,
and phlegm
Prevents illness with hygiene, exercise, herbal preparations, and yoga
Cures with herbal meds, physiotherapy, and diet
P.
State of complete physical, mental, and social well being
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8.
9. 10. 11. 12. 13. 14. 15. 16.
162
TEST YOUR VOCABULARY 2: HERBAL MEDICINE
GROUP 1
1. What herbal medicine is used topically for burns, insect bites and other skin lesions?
2. What is an herbal remedy for ulcerative colitis and other intestinal irritations?
3. Which herbal drug may have an adverse reaction in diabetic patients on oral
hypoglycemics?
4. What is an herbal drug with similar effect to tamoxifen, raloxifene, or fulvestrant?
5. What herbal medicine is used to treat menopausal symptoms?
6. What natural product can be used to acidify urine and prevent E. coli adherence to the
bladder wall (help in UTIs)?
7. What herbal medicine is commonly used to help treat the common cold, URI or flu?
8. A patient with allergies to sunflowers, daisies or ragweed should refrain from taking
what herbal medicine?
9. What herbal drug has positive inotropic and chronotropic effects on the heart?
10. What can be used in the treatment of angina or mild CHF?
11. What herbal drug should be avoided when taking cardiac glycosides (digitalis), anti-
arrhythmics, or beta-blockers?
12. What herbal drug is used to treat varicose veins or hemorrhoids?
13. Benign Prostatic Hypertrophy can be treated with what herbal remedy?
14. What herb inhibits the re-uptake of serotonin, NE, and dopamine?
15. What is the adverse reaction to St. John's Wort?
16. Why should St. John's Wort not be given to people on other allopathic medications?
17. What herb is used as a sedative, often before bedtime?
18. You should avoid taking valerian with what allopathic medications?
163
GROUP 2
A.
Hawthorn, which dilates coronary vessels and has a positive ino- and chronotropic
effect on the heart.
B.
Horse chestnut seed extract inhibit enzymes that breakdown capillary wall proteins.
They are used to help treat varicose veins or hemorrhoids.
C.
Photosensitivity, xerostomia, sexual dysfunction
D.
Valerian increases GABA and is used to treat insomnia and anxiety. Take orally 30
minutes before bed.
E.
Saw Palmetto.
F.
Hawthorn
used in mild CHF and angina
G.
Echinacea
It has antiinflammatory property and is thought to promote macrophage activity against
microorganisms!
Echinacea should not be used as a prophylactic, limit its use to treatment and use no
more than 2 weeks.
H.
Black Cohosh.
It binds estrogen receptors. It can be used in patients with breast cancer.
Black cohosh also suppresses LH secretion.
I.
Aloe Vera is an herbal remedy for GIT irritations.
Side effects= cramping, diarrhea
J.
Cranberry!
K.
Aloe vera
164
L.
Avoid Hawthorn when taking drugs for arrhythmias.
M.
St. John's Wort inhibits catecholamine reuptake. It can therefore be used in depression.
N.
Avoid valerian with CNS depressants... recall, valerian increases GABA, which is a CNS
depressant. There will therefore be additive effects with other CNS depressors such as
barbiturates, benzodiazepines, alcohol...
O.
St. John's Wort induces the CYP450 system, and therefore increases the metabolism of
other drugs!
It also decreases iron absorption, so Fe2+ levels must be watched
P.
Aloe Vera taken orally for GIT problems: it may decrease blood sugar, thereby
promoting hypoglycemia in patients on oral hypoglycemics.
Q.
Black Cohosh
R.
Echinacea should be avoided by these patients
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8. 9.
10. 11. 12. 13. 14. 15. 16. 17. 18.
165
TEST YOUR VOCABULARY 3: YIN/YANG THEORY
GROUP 1
1. Definition of Yin Yang theory
2. Yin/Yang is relative, not absolute in the following ways.
3. Contents of Yin/Yang Theory
4. Definition of Excess Yang
5. Definition of Excess Yin
6. Definition of Deficient Yang
7. Definition of Deficient Yin
8. Etiology of Excess Yang
9. Etiology of Excess Yin
10. Etiology of Deficient Yang
11. Etiology of Deficient Yin
12. Symptoms of Excess Yang
13. Symptoms of Excess Yin
14. Symptoms of Deficient Yang
15. Symptoms of Deficient Yin
16. Treatment of Excess Yang
17. Treatment of Excess Yin
18. Treatment of Deficient Yang
19. Treatment of Deficient Yin
20. Yang excess causes...
21. Yin excess causes...
22. Yang deficiency causes...
23. Yin deficiency causes...
24. Yin-Yang describe the two ……………. aspects of things and phenomena and their
interrelation in the natural world.
GROUP 2
A.
1) pale face
2) aversion to cold
166
3) chills
4) shivering
5) cold extremities
6) no sweating
7) normal tongue body, thin white coating
8) superficial/floating and tight pulse (like twisted rope)
9) all above symptoms cannot be released by warming
B.
1) menopause syndrome: hot flash, night sweating, red cheeks
2) low-grade fever (not over 100)
3) tidal fever (5:00 to 7:00 PM)
4) thirsty, dry-mouth but only sip water at night
5) tongue body red & small, peeled w/cracks, map/geographic coating, maybe yellow or
mirror
6) pulse is deep, weak, thin and fast
C.
Tonify with warming therapy
- Acu w/moxa on lower parts of body, lower abdomen and back
- Herbally warm or hot, less pungent/acrid, e.g. deer meat, shrimp, lychee
D.
Excessive Cold Syndrome
E.
Empty/Deficient Heat Syndrome
F
Yin and Yang represent two relevant phenomenon or things which have opposite but
complementary properties. Yin and Yang can also represent two relevant parts of one
phenomenon or thing.
G
1) opposition of Yin/Yang
2) Inter-dependence of Yin & Yang (support, define)
3) mutual consumption of Yin & Yang (change in quantity)
4) inter-transformation (change in quality/property)
H
1. Invasion of Yin type external pathogens (cold, dampness, dryness)
2. Diet- raw, cold (in property and temp), slippery foods (seaweed), ice water
3. Emotion disorder- stress, depression
I
4 greats:
1) great fever
2) great thirst, desire for cold drinks
167
3) great sweating
4) great pulse: overflowing, forceful and fast( over 90/min)
other symptoms: red face over all face, throbbing headache, red tongue body, dark
yellow urination, loud voice
J.
Sedate
- white tiger concoction with gypsum
- blood letting
- cold food
K.
1) Under certain conditions, property of Yin/Yang can be changed.
2) Yin/Yang can be divided limitlessly.
3) Yin and Yang contain the seed of the opposite.
L.
Yin part of human body is above or beyond or more than average, which makes Yin
absolutely too much.
M.
1. Invasion of external yang type pathogens (wind, summer heat, fire/fire) 2. Emotion
disorders- anger, resentment 3. Diet- spicy and hot, coffee (irritable bowel syndrome,
colitis), alcohol (over 40-50%), fried food, better to steam or boil food
N.
1. A chronic stage of invasion of Yang pathogens
2. Over working- too much studying
3. A chronic stage of overeating Yang food
O
1) pale face
2) fatigue and weakness
3) cold extremities
4) impotence, premature ejaculation, lower libido
5) clear & frequent urination
6) cold pain, desire for warming & touching
7) all symptoms can be relieved by warming
8) tongue body pale, swollen with teeth marks, white coating, wet, moistened
9) pulse is deep, weak and slow
P.
Yang part of the human body is below the average, therefore Yang cannot control Yin;
Yin becomes relatively too much.
168
Q.
Sedate
- Apply warm/hot herbs, acrid/pungent
- make patient sweat
- remove yin
R.
Tonify
Acu needling pts from Yin channel, e.g. K3, Sp6
Herbal Yin-nourishing herbs, e.g. Shu Di Huang
To nourish Yin, dietary supplements are better than acupuncture.
S.
Excessive Heat Syndrome
T
Yang part of human body is more than the average; becomes absolutely too much.
U
Yin part of the body is below the average, therefore Yin cannot control the Yang; Yang
becomes relatively too much.
V
1. A chronic stage of invasion of Yin pathogens
2. Overworking- too much sex
3. A chronic stage of overeating Yin food
W.
Empty/Deficient Cold Syndrome
X.
Opposite
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8.
9. 10. 11. 12. 13. 14. 15. 16.
17. 18. 19. 20. 21. 22. 23. 24.
169
TEST YOUR VOCABULARY 4: MERIDIANS
GROUP 1
1. Meridians/ Jing Luo

2. Name 12 Main Meridians
3. Functions of the Channels
4. Yin Organs
5. Yang Organs
6. Jing Luo
7. Jing
8. Luo
9. Meridians
10. Functions of Meridians
11. Clinical Application of Channels
12. Meridians as a Medium to Adapt to Environmental Changes
13. Name 3 Yin Channels of hand
14. Name 3 Yang Channels of Hand
15. Name 3 Yin Channels of Foot
16. Name 3 Yang Channels of Foot
17. Directional Flow of Qi
18. Yin Channels
19. Yang Channels
20. Properties of Yin and Yang
GROUP 2
A.
Transport qi and blood through the body, Integrate the parts of the body, Protect the
body, Connect the interior of the body with the exterior, Transmit qi to the diseased area
via stimulation, Pathologies are expressed via the channels.
B.
To go through or to thread and attach like a net
C.
Anterior: Spleen/ Taiyin, Middle: Liver/ Jueyin, Posterior: Kidney/ Shaoyin
170
D.
Flow upward through chest into arms and hand
E.
Chest > Hand > Face > Foot > Chest
F.
The networks of the body that carries Qi, linking all the organs and bodily substances
and unifies all the parts of the body into an interlacing whole. 72 total but accupressure
uses only 14
G.
Means paths, water channels, main branches run longitudinally and internally
H.
Transport Qi and Blood through the body, integrating in into a whole, Regulate yin and
yang within body, Protect the body, Channels distribute Qi to diseased areas.
I.
Anterior: Large intestine/ Yangming, Middle: Sanjiao(Triple Heater)/ Shaoyang,
Posterior: Small Intestine/ Taiyang
J.
Explain pathological changes, Guide to clinical diagnosis/ assessment, Guide to
treatments
K.
Lung> Large Intestine> Stomach> Spleen> Heart> Small Intestine> Urinary Bladder>
Kidney> Pericardium> San Jaio> Gall Bladder> Liver> back to lung
L.
Large Intestine, Stomach, Small Intestine, Urinary Bladder, San Jaio, Gall Bladder.
M.
To attach or network, branches thinner and smaller, run transversely and superficially
over body
N.
Protective, Biorhythmic, Communication, Maintenance, Energetic, Healing
O.
Anterior: Stomach/ Yangming, Middle: Gallbladder/ Shaoyang, Posterior: Bladder/
Taiyang
P.
Flow downward from fingertips through head and down to feet
171
Q.
Anterior: Lung channel of hand Taiyin, Middle: pericardium channel of hand Jueyin,
Posterior: Heart channel/ Shaoyin
R.
Penetrate zang fu organs, extraordinary organs, connect with the skin, muscles, flesh,
tendons, bones, head, body trunk and limbs and sense organs- linking all tissues of the
body into an integrated whole
S.
Lung, Spleen, Heart, Kidney, Pericardium, Liver
T.
Yin: inward, cold, dark
Yang: outward, warm, bright
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
11 12. 13. 14. 15. 16. 17. 18. 19. 20.
172
TEST YOUR VOCABULARY 5: QI, BLOOD, BODY FLUIDS
GROUP 1
1.Blood Pathologies
2.Qi Pathologies
3.Qi- Blood Relationship
4.Engendering organs of body fluid
5. Excess/ Full/ Shi is characterized by...
6.Blood Engendering Organs
7.Engendering organs of Qi
8.Three aspect of Qi
9.Five relations of Qi & Blood
10.Blood management organs
11.Five Fx of Zong Qi
12. Xu/ Deficiency/ Empty/ Vacuity is characterized by...
13.Blood Heat
14.Three Fx of Jin Ye
15.Blood's Fx
16.Blood Vacuity/ Xu/ Deficiency
17.Jin (minor) pathologies
18.Ye (Major) pathologies
19.Symptoms of Blood stasis
20.Sign of Blood stasis
21.Yang consumes
173
22. Classify which of the 5 zang organs are yin or yang
GROUP 2
A.
Xu
Sinking
Stagnation
Rebellious
B.
The presence of a pathogenic factor
C.
Lung- upper source
Spleen- Movement/ transformation
Kidney- Water organ
D.
Moisten- organs sinews, flesh, skin, mucous membranes, orifices
Lubricate- joints
Nourish- Brain, marrow, bones
E.
Weakness of the body's Qi
F.
Thirst
rough dry tongue
dry throat, lips, tongue, skin, stool
short void of scanty urine
G.
Diarrhea
Profuse urination
vomiting
great sweat
great fever
H.
Qi generates, moves, hold blood
Blood is the mother of Qi
I.
- Nourish the HT. Enhance+promote the Fx of governing the Blood and vessels
174
- Nourish the LU. Enhance+promote the Fx of controlling Qi and respiration
- Controls speech and str. of voice
- Promotes blood flow to the extremities.
- Interacts w/ Yuan Qi to regulate breathing and the KD.
J.
- Qi engenders Blood
- Qi is the commander of blood. If Qi moves blood moves. If Qi J stops Blood stops.
- Qi is the commander of blood. It is qi that contains the blood in the vessels.
- Qi and Blood flow together. Therefore, Qi deserts with Blood.
- Blood is the mother of qi, it is the material basis to anchor Qi.
K.
The most rarefied form of matter
All movement & transformation in the universe is because of Qi
Qi is the Fx on the organs
L.
"Primarily" Febrile disease
Liver heat (gio)
Ejection of bright red blood
Maculopapular eruptions
Vexation
Crimson tongue
M.
Heavy blood loss
Diminished production from; HT,SP,KD
Flowery vision
Palpitations
Pale complexion in tongue, lips, nails
Fine, thin pulse
Hypertonicity
Dry skin, lifeless hair
N.
Pain; stabbing and fixed
Masses; fixed
Bleeding; recurrent, purple/blue clots
Dull dark complexion
Tongue, static macules
Skin; spider nervi, bruises
O.
body fluids
175
P.
Heart- moves
Spleen- makes
Liver- treasures "stores"
Q.
Heart- Fx is to engender
Spleen- Gu qi
Kidney- Maternal essence
R.
Nourish the body
Moisten body tissues
The material foundation to house the spirit
Blood is the mother of Qi
S.
Trauma, Bleeding, Qi stagnation, Qi xu, blood heat/cold
T.
Stasis
Xu/ Vacuity
Heat/ Cold
U.
Lung
Spleen
Kidney
V.
yang=1)heart and 2)lung

yin=3)liver 4)spleen and 5)kidney
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.
176
TEST YOUR VOCABULARY 6: VITAL SUBSTANCES 1
GROUP 1
1. What are the four Vital Substances?

2. What are the Three Treasures?
3. Define Essence...
4. What types of Essence are there?
5. Where do you get Congenital Essence from?
6. Where do you get Acquired Essence from
7. Where is Essence stored?
8. What are the four functions of Essence?
9. Define Qi:
10. What are some sources of Qi?
11. Can you name some differences between Qi and Essence?
12. Name the 6 types of Qi
13. What are the six functions of Qi?
14. Where does Primary Qi (Yuan Qi) derive from and where is it located?
15. What are Primary Qi's (Yuan Qi) functons?
16. How can Acupuncture tonify Yuan Qi?
17. How can herbs, food and exercise tonify Yuan Qi?
18. What are the two types of Food Qi (Gu Qi)?
19. Where is Nutritive Qi (Ying Qi) located?
20. What are the two functions of Nutritive Qi (Ying Qi)?
21. Where is Defensive Qi (Wei Qi) located?
22. What are the four functions of Defensive Qi (Wei Qi)?
23. Can you name some differences between Ying Qi and Wei Qi?
24. The 5 flavors of YANG and YIN
177
GROUP 2
A.
1.) Tonify the Primary Source points on each channel
2.) Tonify Ren4 and Ren6 (located @ Lower Dan Tian)
3.) Tonify Du4 (for Kidneys and Mingmen)
B.
Air - comes from Heaven and is related to the Lungs; also known as Da, Dan, Big or
Qing Qi.
Food - comes from the Earth; made of of Ying Qi (Nutritive Qi) and Wei Qi (Defensive
Qi); is collectively called Gu Qi; related to the Spleen.
Congenital - comes from your parents; known as Primary or Yuan Qi; most important
dose of Qi you get and there is a fixed limit.
C.
1.) Transformation- SP Qi transforms food into Ying Qi and Wei Qi; Yuan Qi transforms
into all other organ Qi.
2.) Transportation- Heart is #1 organ for this
3.) Protection- Wei Qi
4.) Warming
5.) Raising- SP Qi controls raising; Primary Qi
6.) Holding- prevents leakage
D.
1.) Ginseng (Renshen; should be 10+ years old)
2.) Bone soup or dried nuts
3.) Qi Gong
E.
1.) Ying Qi is sticky part of food essence; Wei Qi is clear and light part of food essence.
2.) Ying Qi is static and flows slowly with blood; Wei Qi is dynamic
3.) Ying Qi flows in blood vessels and is more localized and deeper; Wei Qi flows
outside of blood vessels, runs everywhere and is more superficial
4.) Ying Qi is Yin in nature; Wei Qi is more Yang in nature.
BOTH ARE CARRIERS OF THE SHEN!!
F.
Qi, Blood, Essence, and Body Fluids
G.
You get Acquired/Postnatal/Post-Heaven Essence from food, water, air and Qi Gong.
H.
Qi is a refined energy, produced by the internal organs, which has the function of
nourishing the physical body and the mind. It is part of the vital substances.
178
Qi indicates the functional activities of the internal organs. All internal organ qi derives
from the essence of the Kidneys.
I.
Primary Qi (Yuan Qi)
Ying Qi (Nutritive Qi)
Wei Qi (Defensive Qi)
Gathering/Collective Qi (Zong Qi)
True Qi (Zhen Qi)
Up-Right Qi (Zheng Qi)
J.
Blood Vessels; Ying Qi is one of the components of Blood (along with Body Fluids); it is
produced in the heart from materials provided by the Spleen.
K.
Essence, Qi and Shen
L.
Governs growth, birth, reproduction and development.
Essence is the basis of Kidney Qi
Essence produces marrow (brain, spine and bones)
Essence is the basis of constitutional strength
M.
Qi is energy-like; Essence is fluid-like
Qi is Yang in nature; Essence is Yin in nature
Qi runs everywhere; Essence is stored in Kidneys
Qi is dynamic; Essence is static
Qi is more superficial; Essence is deep within body
Qi is easily tonified; Essence is hard to tonify/replenish
N.
1.) Motivating force; supports whole body functioning.
2.) Basis of Kidney Qi (shared fx of Essence)
3.) Facilitates the transformation of Qi
4.) Facilitates transformation of Blood
O.
Between the soft tissues of the skin and the muscles, but outside of the blood vessels; it
is considered more superficial than Ying Qi
P.
fluid-like vital substance, the most basic and important of the vital substances to the
body. The transformation for all other vital substances relies on Essence.
179
Q.
Kidneys
R.
It is derived from Kidney Essence and is located in the lower Dan Tian (specifically the
Mingmen, which is the space between the Kidneys).
S.
Nutritive Qi (Ying Qi)
Defensive Qi (Wei Qi)
T.
1.) Protection
2.) Control opening and closing of pores
3.) Maintains body temp
4.) Strengthen skin and muscles
U.
Congenital Essence and Acquired Essence
V.
1.) Nourish internal organs and body tissues
2.) Moisten internal organs and body tissues
W.
You get Congenital/Prenatal/Pre-Heaven Essence from your parents
X.
acrid/sweet/light/dispersing herbs are YANG

sour/bitter/salty/draining herbs are YIN
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8.
9. 10. 11. 12. 13. 14. 15. 16.
17. 18. 19. 20. 21. 22. 23. 24.
180
TEST YOUR VOCABULARY 7: VITAL SUBSTANCES 2
GROUP 1
1. What is the source/location of Zong Qi and where is Zong Qi (Collective/Gathering

Qi) located?
2. What are the five functions of Zong Qi (Collective/Gathering Qi)?
3. What is the SOURCE of blood?
4. What GENERATES the Blood?
5. What is the Blood's relationship to the Spleen?
6. What is the Blood's relationship to the Heart?
7. What is the Blood's relationship to the Liver?
8. What is the Blood's relationship to the Lungs?
9. What is the Blood's relationship to the Kidneys?
10. What are the three general functions of Blood?
11. Name three characteristics of the relationship between QI TO BLOOD.
12. Name two characteristics of the relationship between BLOOD TO QI.
13. What is Blood's relationship with Essence?
14. What is Zheng Qi (Up-Right Qi) ?
15. What is the function of Zheng Qi (Up-Right Qi)?
16. The 4 qi of herbs:
GROUP 2
A.
Spleen and Stomach; they collect the building blocks for Blood (Ying Qi and Body
Fluids)
B.
The Heart governs Blood by generating Blood and transporting Blood.
The Heart controls the Blood Vessels.
C.
Zong Qi is made up of Air (Clear Qi) and Food Qi (Gu Qi). Since Gu Qi is made up of
Ying Qi and Wei Qi, that means they are also a part of Zong Qi.
Zong Qi = Clear Qi + Ying Qi + Wei Qi
181
Zong Qi is located in the chest, midway between the breasts at Ren17 (Sea of the Qi)
D.
Provides the Yuan Qi and Essence necessary for Blood generation.
G.
1.) Qi generates/transforms Blood (via Ying Qi, Spleen and Heart Qi)
2.) Qi moves Blood (via Heart Qi)
3.) Qi holds Blood (Spleen Qi prevents bleeding)
E.
1.) Blood nourishes & moistens Qi
2.) Blood provides a dense basis to Qi & prevents Qi from floating and scattering
F.
It is the sum of all healthy Qi; It is opposite of Evil Qi
H.
1.) Nourish Heart and Lungs
2.) Enters throat and boosts the Lung function and supports respiration
3.) Enters Heart and Blood Vessels to promote blood circulation
4.) Controls volume of voice
5.) Controls sensation and movement of extremities
I.
The Liver stores Blood.
Regulates Blood flow.
Controls menstruation.
J.
The Spleen is involved in the transformation and generation of Blood by supplying the
ingredients (Ying Qi and Body Fluids).
It holds and wraps the Blood Vessels to prevent leaking/bleeding.
K.
Heart
L.
Lungs control Blood Vessels and creates a rhythm thru respiration.
Cleans the blood.
M.
Resistance or defense and healing.
182
N.
1.) Nourishing (Ying Qi)
2.) Moistening (Body Fluids)
3.) As substantial basis of Shen
O.
Mutually supportive
P.
warm/hot belong to Yang
cool/cold belong to Yin
ANSWER BOX
1. 2. 3. 4. 5. 6. 7. 8.
9. 10. 11. 12. 13. 14. 15. 16.
183

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UNIT

I. The purpose of the functional evaluation

There are two types of examination:

1. The human tree of life

- 6 Roots: 6 vital substances:

JING – XUE – QI – QI – SHEN – JIN YE (Chinese)

TINH – MÁU – KHÍ – KHÍ – THẦN - TÂN DỊCH (Vietnamese)

HORMONES – BLOOD – ENERGY – STRENGTH – MENTAL – BODY FLUID

- 12 BRANCHES: 12 Basic Functions (YIN and YANG) 12 Meridians.

- 6 LEAVES: 6 General Functions:

WOOD – FIRE – EARTH – METAL – WATER – SOURCE

- 2 FACES of the LEAF: a YIN face and a YANG face.

2. Purpose of functional evaluation

The purpose of the Functional Evaluation is primarily to answer 4 questions:

Functional Evaluation of the 12 Functions or 12 Meridians or 6 SYSTEMS.

b. What is the condition of the 6 LEAVES?

Functional Evaluation of the 6 GENERAL FUNCTIONS and the MAIN CAUSE.

d. What is the condition of the two sides of the leaf?

Functional Evaluation of Emptiness or Fullness Patterns of YIN or YANG, of

II. THE RESULTS OF THE FUNCTIONAL SIX VITAL SUBSTANCES

We must answer the first question of the functional evaluation:

What is the state of six roots of the Human Tree of life?

JING – XUE –QI – QI – SHEN – JIN YE

III. THE FUNCTIONAL EVALUATION OF THE 6 SYSTEMS OR 12 FUNCTIONS OR

Each of the 6 SYSTEMS contains a number of functions. The symptoms of the

6 SYSTEMS 12 BASIC FUNCTIONS

Respiratory System Lung – Large Intestine

MO points, SHU points, sensitive points

IV. THE FUNCTIONAL EVALUATION OF THE 6 GENERAL FUNCTIONS.

The 6 GENERAL FUNCTIONS and their relationship: SHENG and KO cycle.

V. THE FUNCTIONAL EVALUATION OF YIN AND YANG

Each of the GENERAL FUNCTIONS possesses 2 Basic Functions or 2 opposite

YANG stimulates the function.

YIN inhibits the function.

There are two possible states: EMPTYNESS or FULLNESS:

EMPTYNESS or deficiency of YANG or YIN: XU state. FULLNESS or excess of YANG

We can diagnose EMPTYNESS or FULLNESS States by 4 criteria:

The Functional Evaluation in Traditional Oriental Medicine helps us to understand the

- The state of the 6 Vital Substances.

- The Dysfunction of the systems and Meridians.

The Functional Evaluation guides us to the elaboration of treatments.

I. JING: THE RENAL HORMONES

1. The STRUCTURE of the URO-GENITAL SYSTEM and the HORMONES

2. The FUNCTIONS of the URO-GENITAL SYSTEM

Blood – Bones – Muscles – Hair – Teeth

Memory – Will – Intelligence – Wisdom

c. Stabilization of Body Fluids

e. Defense of the body, body resistance

3. THE SYMPTOMS OF DEFICIENCY OF THE ROOT JING

b. Lower back pain

d. Deficiency of sexual activity

f. Deficiency of the urinary function

i. State of stress psycho-physical: cold, heat, fear.

II. XUE – MÁU – BLOOD

There are 3 Sources of Production of the BLOOD:

 Original Digestive BLOOD

2. The functions of the digestive system for the production of blood